Using data on more than 250,000 emergency department (ED) visits, we study the time-of-day effect on physician decision-making and patient outcomes. After controlling for patient characteristics, physician fixed effects, and work hours, we find that cases treated at night have significantly lower probability of inpatient admission and involve fewer medical tests. These cases are also more likely to revisit the ED, which supports the decline in physician performance. While we cannot completely rule out the possibility of limited hospital arrangements, our findings are most consistent with the detrimental effect of disrupted circadian rhythms during night shifts.
Using administrative data from a large and diverse emergency department (ED), we examine the impact of race concordance between patients and physicians on physician decisionmaking and patient health outcomes. We find that patient-physician race concordance increases consultation time and decreases the probability of inpatient admission and diagnostic testing. Subsequently, race-concordant patients have lower revisit rates after ED discharge. The effect of race concordance is largely driven by patients who had less serious illnesses and whose diseases had nonspecific symptoms or less clear causes. The results are best explained by the informational and communication mechanism.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.