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The physician market Part 1
1. The Physician Market, Part 1 Professor Vivian Ho Health Economics Fall 2007 These slides draw from material in Santerre & Neun, Health Economics, Theories, Insights and Industry Studies, Thomson 2007.
5. *The AMA defines primary care as including family practice, general practice, internal medicine, obstetrics/gynecology, and pediatrics. Physician Market Structure (cont.)
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15. Production, Costs, and Economies of Scale $7.26 (1.08) $35.36** (2.12) Test interpretation $4.84 (1.35) $12.14** (2.16) Hospital visit $14.77*** (2.91) $22.14*** (3.26) Office visit, est. patient $66.34** (2.00) $59.99* (1.68) Office visit, new patient Marginal non-phys. Costs Full Marginal Cost Output
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34. RESULTS 31,429 in original sample 30,195 located on first review 22,378 negative for screening criteria 7817 positive for screening criteria 7743 reviewed by physicians 6465 without adverse events 1278 with adverse events 972 with no negligence 306 with negligence Figure 1. The Record-Review Process. Numbers of medical records are shown.
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36. STATEWIDE ESTIMATES 27,197 adverse events due to negligence 26,764 with no malpractice claims (98%) 415 malpractice claims (2%) 14,180 with strong evidence of negligence 12,858 with disability 7462 with disability <6mo (58%) 5396 with disability >6mo (42%) 2834 patients <70yo (53%) 2562 patients 70yo (47%)
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39. Rates of Adverse Events and Negligence Specialty Adverse Events Negligence (percentage) (percentage) Orthopedics 4.1 22.4 Urology 4.9 19.4 Neurosurgery 9.9 35.6 Thoracic & Cardiac Surgery 10.8 23.0 Vascular Surgery 16.1 18.0 Obstetrics 1.5 38.3 Neonatology 0.6 25.8 General Surgery 7.0 28.0 General Medicine 3.6 30.9 Other 3.0 19.7 P value <0.0001 0.64