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英文文献：Discontinuity in Care: Practice Closures among Primary Care Providers and Patient Health-护理的中断:初级保健提供者和患者健康之间的实践关闭
英文文献作者：Marianne Simonsen,Lars Skipper,Niels Skipper,Peter R?n? Thingholm
英文文献摘要：
This paper investigates consequences of practice closures among primary care providers on subsequent patient health care utilization and health. Critically, the analysis relies on population-level administrative Danish data that facilitate a unique link between all Danes and their family doctor. We start by characterizing the nature of a practice closure, including the change in provider characteristics that occurs when patients change provider. Practice closure leads patients to choose a systematically younger and less experienced primary care provider. Using a difference-in-differences strategy that compares individuals who experience a practice closing with similar individuals enrolled in similar practices that do not close until later, we next investigate consequences for patient health care utilization and health outcomes. We find that a change in provider due to practice closure increases detection of chronic illness but does not lead to concurrent changes in primary care utilization. We do detect a considerable increase in the use of emergency care, however. A decomposition exercise shows that both physician practice style and the disruption itself plays a role for the total effects but that the direction of their relative influence varies across outcome domains. Importantly, disruption is not always negative from the perspective of the patient.
这篇论文调查了在初级保健提供者之间的实践关闭对随后的病人卫生保健利用和健康的后果。关键的是，分析依赖人口水平的丹麦行政数据，促进了所有丹麦人与其家庭医生之间的独特联系。我们首先描述诊所关闭的性质，包括当病人更换医生时，医生特征的改变。实践封闭导致患者选择一个系统年轻和缺乏经验的初级保健提供者。采用差异中的差异策略，将经历过封闭实践的个体与参与过类似实践但直到较晚才封闭的相似个体进行比较，然后我们调查对患者医疗保健利用和健康结果的影响。我们发现，由于诊所关闭而改变提供者可以增加对慢性疾病的检测，但不会导致初级保健使用的同步变化。然而，我们确实发现急救护理的使用有了相当大的增加。分解练习表明，医生的执业方式和干扰本身都对总体影响起作用，但它们的相对影响的方向在不同的结果领域不同。重要的是，从病人的角度来看，分裂并不总是负面的。
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