Health Affairs

Health Affairs, 26, no. 3 (2007): w324-w337 (Published online 27 March 2007) doi: 10.1377/hlthaff.26.3.w324 © 2007 by Project HOPE	New Online   Getting Health Reform Done   After the State of the Union   Incremental Reform   E-Health in Developing World   Most-Read Articles in 2009

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Variations In Doctor Effort: Evidence From Paraguay

Jishnu Das and Thomas Pave Sohnesen

This paper analyzes how doctors’ practices in Paraguay differ across patients, physicians, and facilities. In the absence of claims or chart data, we constructed a measure of "doctor effort" based on observations of doctor-patient interactions. There is little difference in effort for patients from different backgrounds, but large differences across physicians and facilities. Female doctors, doctors on temporary contracts, and doctors in certain types of facilities provide greater effort; those with higher salaries exert less effort. The results suggest that ensuring access to high-quality care is essential, but whether doctors will discriminate against patients might be less of a concern.

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