title: Provider practice style and patient health outcomes: The case of heart attacks.
abstract: When a patient arrives at the Emergency Room with acute myocardial infarction (AMI), the provider on duty must quickly decide how aggressively the patient should be treated. Using Florida data on all such patients from 1992 to 2014, we decompose practice style into two components: The provider's probability of conducting invasive procedures on the average patient (which we characterize as aggressiveness), and the responsiveness of the choice of procedure to the patient's characteristics. We show that within hospitals and years, patients with more aggressive providers have consistently higher costs and better outcomes. Since all patients benefit from higher utilization of invasive procedures, targeting procedure use to the most appropriate patients benefits these patients at the expense of the less appropriate patients. We also find that the most aggressive and responsive physicians are young, male, and trained in top 20 schools.
authors.affiliation: Princeton University, United States. Electronic address: jcurrie@princeton.edu.
authors.forename: Janet
authors.initials: J
authors.lastname: Currie
authors.affiliation: Columbia University, United States.
authors.forename: W Bentley
authors.initials: WB
authors.lastname: MacLeod
authors.affiliation: Hunter College, CUNY, United States.
authors.forename: Jessica
authors.initials: J
authors.lastname: Van Parys
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D004636:Emergency Service, Hospital; D005260:Female; D005431:Florida; D005102:Health Expenditures; D006801:Humans; D008297:Male; D009203:Myocardial Infarction; D017063:Outcome Assessment, Health Care; D010818:Practice Patterns, Physicians'
keywords: Aggressiveness; Heart attack; Provider practice style; Responsiveness