Physician practice style and patient health outcomes : the case of heart attacks

Author / Creator

Currie, Janet M., author

Available as

Online

Summary

When a patient arrives at the Emergency Room with acute myocardial infarction (AMI), doctors must quickly decide whether the patient should be treated with clot-busting drugs, or with invasive surg...

When a patient arrives at the Emergency Room with acute myocardial infarction (AMI), doctors must quickly decide whether the patient should be treated with clot-busting drugs, or with invasive surgery. Using Florida data on all such patients from 1992-2011, we decompose physician practice style into two components: The physician's probability of conducting invasive surgery on the average patient, and the responsiveness of the physician's choice of procedure to the patient's condition. We show that practice style is persistent over time and that physicians whose responsiveness deviates significantly from the norm in teaching hospitals have significantly worse patient outcomes, including a 7% higher probability of death in hospitals among the patients who are least appropriate for the procedure. Our results suggest that a reallocation of invasive procedures from less appropriate to more appropriate patients could improve patient outcomes without increasing costs. Developing protocols to identify more and less appropriate patients could be a first step towards realizing this improvement.

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