Job Market Candidate
Department of Economics
579 Serra Mall
Stanford, CA 94305
Job Market Paper
User-Generated Physician Ratings—Evidence from Yelp
User-generated physician ratings from online sources are increasingly popular, but since consumers typically lack the ability to evaluate clinical quality, it is unclear whether these ratings actually help patients. Using the universe of Yelp physician ratings matched with Medicare claims, I examine what information on physician quality Yelp ratings reveal, whether they affect patients' choices of physician, and how they influence physician behavior. Through text and correlational analysis, I show that although Yelp reviews primarily describe physicians' interpersonal skills, Yelp ratings are also positively correlated with various measures of clinical quality. Instrumenting physicians' average ratings with reviewers' "harshness" in rating other businesses, I find that a one-star increase in physicians' average ratings increases their revenue and patient volume by 1-2%. Using a difference-in-differences strategy, I test whether, in response to being rated, physicians order more substances that are desirable by patients but potentially harmful clinically. I generally do not find that physicians substantially over-prescribe. Overall, Yelp ratings seem to benefit patients-they convey physicians' interpersonal skills and are positively correlated with their clinical abilities, and they steer patients to higher-rated physicians.
Consolidation of Primary Care Physicians and Its Impact on Healthcare (Draft Embargoed)
With Liran Einav, Jonathan Levin, and Jay Bhattacharya
We use administrative data from Medicare to document the massive consolidation of primary care physicians over the last decade, and its impact on patient healthcare utilization. We show that large physician organizations tend to attract sicker patients, and we employ two research designs that attempt to address this selection and isolate the causal effect of the physician organization size on patient healthcare utilization. The first takes advantage of the heterogeneity in the extent of primary care consolidation across healthcare markets, and the second exploits transitions of physicians across organizations. Our preferred specification suggests that visiting large physician organizations leads to a 16% reduction in the patient's healthcare utilization, and that this reduction is primarily driven by fewer primary care visits and lower utilization of inpatient services.
The Effects of Primary Care Chronic Disease Management in Rural China
With Hui Ding, Min Yu, Jieming Zhong, Ruying Hu, Xiangyu Chen, Chunmei Wang, Kaixu Xie, and Karen Eggleston
Health systems globally face increasing morbidity and mortality from chronic disease, yet many-especially in low- and middle-income countries-lack strong primary care. We analyze China's efforts to promote primary care management for insured rural Chinese with chronic disease, analyzing unique panel data for over 70,000 rural Chinese 2011-2015. Our study design uses variation in management intensity generated by administrative and geographic boundaries-regression analyses based on 14 pairs of villages within two kilometers of each other but managed by different townships. Utilizing this plausibly exogenous variation, we find that patients residing in a village within a township with more intensive primary care management, compared to neighbors with less intensive management, had more primary care visits, fewer specialist visits, fewer hospital admissions, and lower inpatient spending. No such effects are evident in a placebo treatment year. Exploring the mechanism, we find that patients with more intensive primary care management exhibited better drug adherence as measured by filled prescriptions. A back-of-the-envelope estimate of welfare suggests that the resource savings from avoided inpatient admissions substantially outweigh the costs of the program.
The Impact of Import Quotas in The Chinese Movie Industry
With Charles Hodgson
How do local protectionism policies such as foreign movie quota affect the domestic consumers and producers in the Chinese movie market? We answer this question by estimating a nested logit demand system utilizing a unique theater-movie-week level movie performance data set. We find that when the import quota is loosened, there are a modest positive impact on the total revenue and admissions of the industry and a substitution between existing movies and new movies. However, since vertical integration is common between theaters and producers and the increase in revenue of domestic theaters and distributors outweigh the loss of domestic producers, integrated domestic producers may also benefit from less protectionism. Last, we find that inner-land China which are economically poorer and more minority dominant would substitute towards foreign movies more than other regions, indicating potential region-based policy concerns.
Work In Progress
Physician Human Capital and The Economics of Physician Supply
With Jay Bhattacharya
Haibin Wu, Karen N Eggleston, Jieming Zhong, Ruying Hu, Chunmei Wang, Kaixu Xie Yiwei Chen, Xiangyu Chen, Min Yu. 2018. "How do type 2 diabetes mellitus (T2DM)-related complications and socioeconomic factors impact direct medical costs? A cross-sectional study in rural southeast China" BMJ Open 2018;8:e020647.
Haibin Wu, Karen N Eggleston, Jieming Zhong, Ruying Hu, Chunmei Wang, Kaixu Xie, Yiwei Chen, Xiangyu Chen, Min Yu. 2018. "Direct medical cost of diabetes in rural China using electronic insurance claims data and diabetes management data" Journal of Diabetes Investigation.
Yiwei Chen, Lifeng Zhang, and Jiping Huang. 2007 "The Watts-Strogatz network model developed by including degree distribution: theory and computer simulation" Journal of Physics A: Mathematical and Theoretical, 40, 8237-8246.