Tuesday, December 7, 2021

Compared to differences among their male patient counterparts, female patients randomly assigned a female doctor are 5.0% more likely to be evaluated as disabled and receive 8.5% more subsequent cash benefits on average

Gender Differences in Medical Evaluations: Evidence from Randomly Assigned Doctors. Marika Cabral & Marcus Dillender. NBER Working Paper 29541, Dec 2021. https://www.nber.org/papers/w29541

Abstract: While a growing body of evidence documents large gender disparities in health care and related social insurance programs, little is known about what drives these disparities. We leverage administrative data and random assignment of doctors to patients inherent within the workers’ compensation insurance claim dispute resolution process to study the impact of gender match between doctors and patients on medical evaluations and subsequent social insurance benefits received. Compared to differences among their male patient counterparts, female patients randomly assigned a female doctor rather than a male doctor are 5.0% more likely to be evaluated as disabled and receive 8.5% more subsequent cash benefits on average. There is no analogous gender-match effect for male patients. The magnitude of these effects implies that having female doctors evaluate patients entirely offsets the observed gender gap in the likelihood of being evaluated as disabled when male doctors evaluate patients. We explore mechanisms through further analysis of the administrative data and complementary survey evidence. In addition, we present broader evidence on gender gaps in workers' compensation insurance and gender homophily in patients' selections of doctors in settings where patients have choice. Combining this evidence, we conduct policy counterfactuals illustrating how policies increasing gender diversity among doctors or increasing gender homophily in patient-doctor matches may impact gender gaps in evaluated disability. Our findings indicate that policies increasing the share of female patients evaluated by female doctors may substantially shrink gender gaps in medical evaluations and associated outcomes.


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