Physician and Patient Migration to Ambulatory Surgery Centers as a Response to Poor Safety at Hospitals
We hypothesize - 1) that the migration of physicians and patient referrals is, at least in part, a response to poor safety at the hospital, and 2) that the high quality physicians are more likely to lead the change and therefore, may be at the forefront of this migration. Preliminary results indicate that when hospitals are found to have above-normal rates of unnecessary patient care complications (that are unrelated to patient medical condition), the likelihood of physician migration increases by as much as 41 percent. Further, we find that high quality physicians are more likely to choose ASCs over HOPDs when referring them for outpatient procedures. Finally, we find that physicians who have an ownership interest in an ASC are significantly more likely than non-owners to respond to poor performance by the hospital where they have been practicing. The magnitudes of responses, however, vary across types of ownership arrangements.
Key words: Ambulatory Surgical Centers, Hospital Safety, Physician Ownership and Joint Ventures
JEL Classification: I11, L50