Research Background

Race has always been a focal point of international concern. In many contexts, differences in race may lead to inequality and discrimination. In healthcare systems abroad, including countries and regions such as the United States, research suggests that race may influence physicians' decision-making processes and patients’ treatment outcomes. When there is a potential discrepancy in race between doctors and patients, considering racial concordance becomes even more critical.

When analyzing the impact of race on physician decision-making and medical outcomes, healthcare system managers need to determine whether they affect doctors' decisions and patients' treatment outcomes, and then decide whether appropriate interventions are necessary. Patients also require similar judgments as reference points in their decision-making process regarding medical treatment.

Research Data and Methods

This study is based on the emergency department treatment records data from a certain Southeast Asian country. Regression models were used to analyze whether racial concordance affected physicians' consultation and treatment duration, admission rates, the rate of medical test utilization, and patients' readmission rates.

 

Research Findings

The research team found that samples with racial concordance between doctors and patients resulted in an average decrease in admission rates of 8.6%, while consultation and treatment duration increased by 2.3%. These changes were statistically significant. The utilization of medical tests also decreased under the influence of racial concordance, but it was not statistically significant. To address potential endogeneity challenges, the research team used the proportion of on-duty doctors with the same race as the patient as an instrumental variable, validating the reliability of the above findings. The results are shown in Table 2.

Another important finding is that samples with racial concordance between doctors and patients exhibited an average decrease of 3.6% in emergency room readmission rates within one week (specific results shown in Table 4). This change was statistically significant. The research team believes that this provides strong evidence for the beneficial impact of racial concordance on healthcare quality, as it suggests that racial concordance helps to avoid erroneous admission and discharge decisions.

The research team further analyzed the factors behind the above results. Firstly, regarding the phenomenon of patients without racial concordance experiencing higher admission rates and medical test utilization, the research team ruled out discrimination as a cause and speculated that issues related to incomplete information and ineffective communication, common in labor economics, may be underlying factors instead. Further research supported this speculation through two observations. Firstly, the differences induced by concordance were more significant in mild and miscellaneous cases. Secondly, diagnoses made by doctors for patients not meeting concordance criteria were more ambiguous. This suggests that communication and information exchange play crucial roles in the mechanism outlined in this study.

Significance of the Study

This study holds significant implications for healthcare behavior and decision-making. It characterizes important elements and drivers of disparities in medical diagnoses, an issue of high concern, providing theoretical and empirical support for researchers and decision-makers in related fields. Additionally, it presents valuable insights into the effects of intra- and inter-racial interactions, offering important applications for studying the impact of racial characteristics in health and healthcare.

 

Author Backgrounds

Yi Junjian is a distinguished professor at Peking University and a professor of economics at the National School of Development. He is also a dual-appointed professor at the Institute for Global Health and Development. He obtained his Ph.D. from the Chinese University of Hong Kong in 2011. From 2011 to 2014, he conducted postdoctoral research at the University of Chicago's Department of Economics under the supervision of James Heckman (Nobel Laureate in Economics, 2000) and Gary Becker (Nobel Laureate in Economics, 1992). From 2014 to 2020, he served as an assistant professor in the Department of Economics at the National University of Singapore. In 2021, he became an associate professor in the Department of Economics at the Chinese University of Hong Kong. Professor Yi is currently a distinguished professor at Peking University. His research interests focus on health and medical economics, big data analysis in healthcare and health, artificial intelligence economics, human capital theory, labor and population economics, development economics, econometrics, and behavioral economics. His research findings have been published in academic journals in the fields of economics, management, public health, and demography, including the  Journal of Political Economy ,  Review of Economic Studies ,  Management Science ,  Demography ,  Lancet , and  Proceedings of the National Academy of Sciences .

Ye Han, Assistant Professor at Lingnan University in Hong Kong, specializes in health economics, behavioral economics, labor economics, and applied microeconometrics. His research findings have been published in  The Review of Economic Studies ,  Review of Economics and Statistics ,  AEA Papers and Proceedings , and  Management World .

(Interpreted by Waverly Shi)