6 de març 2021

Physician health management skills and patient outcomes


There are large, persistent differences in patient outcomes across physicians and health facilities. The root causes of these differences are not well understood. One reason could be to find if physicians’ health management styles can affect patient health outcomes and health costs.

As quality contracts become increasingly popular across various health care systems, it is important to highlight what facets of individual physicians’ health management styles have meaningful impact on health outcomes and to what extent they vary across physicians. The physician’s ability to correctly diagnose and treat common conditions is one of the central tenets of quality contracts. But the link between these skills and patient outcomes is at best tenuous. Critics have emphasized that unobserved patient-specific characteristics are important and under-researched contributors to the variability of patient health outcomes conditional on physician clinical skill.

Emilia Simeonova et al. published a working paper in 2020 in the NBER where using data on the population of statin users in Denmark between 2004 and 2008 and matching patients to their primary care physicians, they demostrated that

  • The physician’s ability to facilitate adherence with prescription medications (as a proxie of physicians's health management skills) has significant positive effects on patient outcomes and health costs even after controlling for observable and unobservable patient characteristics.
  • It is important to know that when we talk of physician skills is more than reflecting the clinical quality of the physician. Physician skills are related to their ability to make an adequate diagnosis and prescribe the correct treatment.
  • Younger physicians have on average more adherent patients.There didn't find substantial difference in health management skills between male and female physicians after they controlled for physician age and the patient mix. 
  • The interventions aiming at improving physicians’ health management skills as they relate to patient adherence with prescribed therapy will have positive impacts on patient health outcome

Access to NBER working paper (pdf)

photo: Homenatge a Ramon Llull (1976) Josep M. Subirachs ______________________________________________________________________

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