This paper examines how time pressure, an important constraint faced by medical care providers, affects productivity in primary care. We generate empirical predictions by incorporating time pressure into a model of physician behavior by Tai-Seale and McGuire (2012). We use data from the electronic health records of a large integrated delivery system and leverage unexpected schedule changes as variation in time pressure. We find that greater time pressure reduces the number of diagnoses recorded during a visit and increases both scheduled and unscheduled follow-up care. We also find some evidence of increased low-value care, decreased preventive care, and decreased opioid prescribing.

本文研究了时间压力（医疗服务提供者面临的一个重要限制因素）如何影响初级保健的生产力。我们通过将时间压力纳入 Tai-Seale 和 McGuire (2012) 的医师行为模型来生成经验预测。我们使用来自大型集成交付系统的电子健康记录的数据，并利用意外的时间表变化作为时间压力的变化。我们发现，更大的时间压力会减少就诊期间记录的诊断数量，并增加计划和计划外的后续护理。我们还发现一些证据表明低价值护理增加、预防性护理减少和阿片类药物处方减少。