The Value of Specific Knowledge: Evidence from Disruptions to the Patient–Physician Relationship
利用军队医生因部署导致的准随机离职，研究发现初级护理中断使医疗成本增加3%-5%，主要源于专科护理使用增加，且未带来住院率或急诊使用的改善，表明人员流动会损失团队内的知识。
When a member of a work team leaves, some knowledge is lost to the organization. Exploiting quasi-random turnover among military physicians because of deployments, I estimate the effects of turnover on patients and other providers in the same care team. I find that a discontinuity in primary care leads to a 3%–5% increase in costs driven primarily by an increase in the use and intensity of specialty care with no observable benefit to the patient as measured by potential reductions in hospitalization rates and emergency department usage. This indicates that the full cost of turnover includes a reduction in access to knowledge among remaining members of the team. This paper was accepted by Carri Chan, healthcare management. Supplemental Material: The online appendix and data files are available at https://doi.org/10.1287/mnsc.2021.03884 .