Disruptions in primary care: Can resigning GPs cause persistently negative health effects?

We study the effects of general practitioners' (GPs') resignations on their patients' healthcare utilization, diagnoses, and mortality in an event-study setting. Using claims data from a large German statutory health insurance, we find that after physicians leave, their former patients persistently reduce their primary care utilization, only partially substituting it with specialist visits and hospital care. Because patients find a new GP already 1.1 quarters after the old resigns, on average, the persistent effects must be explained through the new GP. Indeed, we find that the new GP serves more patients but performs less diagnostic testing. While we do not find evidence for mortality, our results reveal a substantial decrease in diagnoses of chronic conditions (such as congestive heart failure and diabetes), suggesting that disruptions may have adverse consequences for the efficiency of the healthcare system. This indicates that continuity in primary care is pivotal and shows that the GP has an important role in healthcare delivery.