TITLE:  Physician Workload and Hospital Reimbursement: Overworked Servers Generate Lower Income

SPEAKER:  Sergei Savin

ABSTRACT:

We
study the impact of physician workload on hospital reimbursement
utilizing a detailed data set from the trauma department of a major
urban hospital. We find that the proportion of patients assigned a  "high-severity'' status for reimbursement purposes, which maps, on
average, to a 27.8% higher payment for the hospital, is substantially
reduced as the workload of the discharging physician increases. This
effect persists after we control for a number of systematic differences
in patient characteristics, condition and time of discharge.
Furthermore, we show  that it is not caused by selection bias or
endogeneity in either discharge timing or allocation of discharges to
physicians. Finally, we find that the impact of workload on the
probability that a patient is assigned the high-severity designation is
moderated by the department's past experience in handling certain
patient conditions. We attribute this phenomenon to a workload-induced
reduction in diligence of paperwork execution. We estimate the
associated monetary loss to be approximately 0.9% (with a 95% confidence
interval of 0.3% and 1.5%) of the department's annual revenue.