Please use this identifier to cite or link to this item: https://hdl.handle.net/10419/319344 
Year of Publication: 
2025
Citation: 
[Journal:] Health Economics [ISSN:] 1099-1050 [Volume:] 34 [Issue:] 5 [Publisher:] Wiley [Year:] 2025 [Pages:] 932-955
Abstract: 
ABSTRACT We study the effects of general practitioners' (GPs') resignations on their patients' healthcare utilization and diagnoses in an event‐study setting. Using claims data from a large German statutory health insurance, we find that after physicians leave, their former patients persistently reduce their primary care utilization, only partially substituting it with specialist visits and hospital care. Because patients find a new GP already 1.1 quarters after the old resigns, on average, the persistent effects must be explained through the new GP. Indeed, the new GP serves more patients but performs less diagnostic testing. Our results reveal a substantial decrease in diagnoses of many relevant chronic conditions (such as congestive heart failure and diabetes), suggesting that disruptions may have adverse consequences for the efficiency of the healthcare system. This indicates that continuity in primary care is pivotal and shows that the GP has an essential role in healthcare delivery, particularly in healthcare systems such as Germany, where GPs often have a high workload and little consultation time.
Subjects: 
general practitioners
healthcare expenditure
healthcare utilization
primary care
Persistent Identifier of the first edition: 
Creative Commons License: 
cc-by Logo
Document Type: 
Article
Document Version: 
Published Version
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