Economist: Possible to make health care services more equal and effective by improving the matching process between doctor and patient

It is possible to better utilize the expertise of individual doctors if they are more clearly matched to the needs of patients. This could result in substantial improvements in the health care sector, writes Amanda Dahlstrand in a new SNS report.

The health care sector is facing challenges in terms of budget deficits and staff shortages. This, in turn, highlights the question of how best to utilize the unique skills of the staff. It used to be difficult to determine the skills of individual doctors, but this is now possible by means of new data and methods. This would enable more people to visit primary care doctors who are good at understanding and managing their specific needs, argues Amanda Dahlstrand in the SNS report Matching Doctors and Patients.

“Primary care physicians are expected to be able to handle most things. However, it is reasonable to assume that not everyone is equally good at everything, which is also confirmed in the analysis. This makes a difference when, for example, patients with certain needs are matched with doctors who are particularly good at preventing hospitalizations or avoiding unnecessary prescriptions of antibiotics. There are resources in the primary care sector that could be used in a completely different way than today,” according to Amanda Dahlstrand, assistant professor of economics.

In order to obtain detailed data on the skills of health care staff – and to avoid distortions in the sorting process between patients and doctors – the report analyzes digital health care visits in which patients are assigned a doctor via a drop-in system. It is easier to influence matching in a digital health care setting. Not only does it allow for a more flexible allocation of doctors to patients, but the range of doctors will also be greater if geographical distances do not matter. However, in metropolitan regions – where many doctors are found within a reasonable distance – it is probably also possible to achieve a better match when it comes to physical visits to the doctor. Furthermore, according to Amanda Dahlstrand, it is possible to achieve significant gains here.

“By simply introducing a better matching between doctors and patients,” she argues, “we could reduce the number of avoidable hospitalizations by 8 percent and the number of prescriptions of antibiotics violating the guidelines by 3 percent.”

Dahlstrand also shows that in some cases, it may be more effective to focus on better matching rather than further training initiatives for primary care doctors. This is due to the fact that there are already doctors who are particularly good at treating certain conditions, who may then assist the patients in need of such skills.

By analyzing existing data on patients’ previous health care visits, it is possible to identify the needs of patients. Patients with a lower social and economic status face a particularly high risk of suffering certain negative outcomes. Health care services could be made more equal if more of these patients were to see doctors with special skills.

“Primary care could become more equal and effective by means of better matching between doctors and patients. This model offers opportunities that decision-makers should be aware of,” says Amanda Dahlstrand.

about the project

Matching Doctors and Patients is part of the SNS research project “Organizing and Financing Health Care and Elderly Care,” which runs from 2021 to 2024. The overall issues addressed in the project are: What might the public commitment look like with regard to health care and elderly care in the future? And how is it to be financed?

about the author

Amanda Dahlstrand is an assistant professor of economics at the University of Zurich.