Physician education mix and patient case-mix in hospital

Abstract Background Previous literature pays little attention on relationship between hospital case-mix and physicians’ human capital, while it is truly important topic in studies about health workforce. A multi-tiered medical education system resulted in substantial variation in physician education mix in hospital. We first exploit this heterogeneity in physician human capital across hospitals to explore its role as one of determinants of hospital case-mix. Methods The hospital case-mix index (CMI) from DRGs system is dependent variable. The school years of medical education is used to measure variation in physician human capital, that can be aggregated and averaged by each hospital. The study uses both descriptive analysis and regression modelling to investigate this association. Results Descriptive results show a positive relationship between physician human capital and patient case-mix in hospital. The model results illustrated that hospitals have higher level of physician education tend to have more serious case mix. In specific, when average medical school years increased by one, the hospital CMI increased by nearly 0.05. Conclusion The study findings highlight the importance and influences of physicians’ education mix in patients’ outcomes and healthcare delivery. We argue that physician groups with lower human capital are more likely to manage case volume with lower CMI. For future health care studies in some unstandardized health care system, it is important to control for physician-level variation in education.