Information asymmetry, insurance, and the decision to hospitalize
AbstractIn a theoretical model, we analyze the effects of various kinds of demand- and supply-side incentives in the context of a model in which patients and doctors must decide not only on an aggregate quantity of health services to use in treating various kinds of illness, but also have a choice between different kinds of providers (in particular, outpatient services rendered by primary-care physicians or inpatient services provided by hospital-based specialists). We present two broad models, the traditional fee-for-service payment scheme and a managed care setup where physicians are paid via capitation, and analyze them both with and without information asymmetry. We find that under certain plausible conditions, second-best optimal managed care plans may dominate second-best optimal conventional plans that rely on cost control through demand-side cost sharing. Ã l'aide d'un modÃ¨le thÃ©orique dans lequel patients et mÃ©decins doivent choisir la quantitÃ© de service Ã utiliser ainsi que celui, de l'omnipraticien ou du spÃ©cialiste uvrant Ã l'hÃ´pital, qui fournira ces services, nous analysons diffÃ©rents mÃ©canismes d'incitation agissant sur l'offre et la demande. Nous Ã©tudions essentiellement deux modes d'organisation : le systÃ¨me conventionnel de rÃ©munÃ©ration Ã l'acte et le systÃ¨me de gestion intÃ©grÃ©e des soins avec une rÃ©munÃ©ration per capita; Ã la fois en prÃ©sence et en l'absence d'asymÃ©trie d'information. Nous obtenons comme rÃ©sultat qu'Ã certaines conditions plausibles, l'optimum de second-rang auquel mÃ¨ne le systÃ¨me de gestion intÃ©grÃ©e est supÃ©rieur Ã celui que donne le systÃ¨me conventionnel de rÃ©munÃ©ration Ã l'acte qui rÃ©percute une partie des coÃ»ts sur l'utilisateur.
Download InfoIf you experience problems downloading a file, check if you have the proper application to view it first. In case of further problems read the IDEAS help page. Note that these files are not on the IDEAS site. Please be patient as the files may be large.
As the access to this document is restricted, you may want to look for a different version under "Related research" (further below) or search for a different version of it.
Bibliographic InfoArticle provided by Elsevier in its journal Journal of Health Economics.
Volume (Year): 24 (2005)
Issue (Month): 4 (July)
Contact details of provider:
Web page: http://www.elsevier.com/locate/inca/505560
Other versions of this item:
- Åke Blomqvist & Pierre Thomas Léger, 2002. "Information Asymmetry, Insurance, and the Decision to Hospitalize," CIRANO Working Papers 2002s-06, CIRANO.
- Åke Blomqvist & Pierre Thomas Léger, 2001. "Information Asymmetry, Insurance, and the Decision to Hospitalize," Cahiers de recherche 01-03, HEC Montréal, Institut d'économie appliquée.
- Åke Blomqvist & Pierre Thomas Léger, 2003. "Information Asymmetry, Insurance, and the Decision to Hospitalize," Departmental Working Papers wp0305, National University of Singapore, Department of Economics.
- I1 - Health, Education, and Welfare - - Health
Please report citation or reference errors to , or , if you are the registered author of the cited work, log in to your RePEc Author Service profile, click on "citations" and make appropriate adjustments.:
- Pierre Thomas Léger, 2000. "Quality control mechanisms under capitation payment for medical services," Canadian Journal of Economics, Canadian Economics Association, vol. 33(2), pages 564-586, May.
- Ching-to Albert Ma & Thomas G. McGuire, 1995.
"Optimal Health Insurance and Provider Payment,"
0059, Boston University - Industry Studies Programme.
- Manning, Willard G, et al, 1987. "Health Insurance and the Demand for Medical Care: Evidence from a Randomized Experiment," American Economic Review, American Economic Association, vol. 77(3), pages 251-77, June.
- Marinoso, Begona Garcia & Jelovac, Izabela, 2003. "GPs' payment contracts and their referral practice," Journal of Health Economics, Elsevier, vol. 22(4), pages 617-635, July.
- Dranove, David, 1988. "Demand Inducement and the Physician/Patient Relationship," Economic Inquiry, Western Economic Association International, vol. 26(2), pages 281-98, April.
- Gravelle, Hugh & Dusheiko, Mark & Sutton, Matthew, 2002. "The demand for elective surgery in a public system: time and money prices in the UK National Health Service," Journal of Health Economics, Elsevier, vol. 21(3), pages 423-449, May.
- Glied, Sherry, 2000. "Managed care," Handbook of Health Economics, in: A. J. Culyer & J. P. Newhouse (ed.), Handbook of Health Economics, edition 1, volume 1, chapter 13, pages 707-753 Elsevier.
- Rochaix, Lise, 1989. "Information asymmetry and search in the market for physicians' services," Journal of Health Economics, Elsevier, vol. 8(1), pages 53-84, March.
- Allard, Marie & Jelovac, Izabela & Léger, Pierre Thomas, 2011.
"Treatment and referral decisions under different physician payment mechanisms,"
Journal of Health Economics,
Elsevier, vol. 30(5), pages 880-893.
- Marie Allard & Izabela Jelovac & Pierre-Thomas Léger, 2011. "Treatment and referral decisions under different physician payment mechanisms," Post-Print halshs-00650933, HAL.
- Michael Leung, 2010. "Primary care delivery, risk pooling and economic efficiency," The European Journal of Health Economics, Springer, vol. 11(2), pages 161-175, April.
- David, Guy & Neuman, Mark D., 2011. "Physician division of labor and patient selection for outpatient procedures," Journal of Health Economics, Elsevier, vol. 30(2), pages 381-391, March.
- Boris Kralj & Jasmin Kantarevic, 2013.
"Quality and quantity in primary care mixed-payment models: evidence from family health organizations in Ontario,"
Canadian Journal of Economics,
Canadian Economics Association, vol. 46(1), pages 208-238, February.
- Kantarevic, Jasmin & Kralj, Boris, 2011. "Quality and Quantity in Primary Care Mixed Payment Models: Evidence from Family Health Organizations in Ontario," IZA Discussion Papers 5762, Institute for the Study of Labor (IZA).
- Ake Blomqvist & Colin Busby, 2012. "How to Pay Family Doctors: Why "Pay per Patient" is Better Than Fee for Service," C.D. Howe Institute Commentary, C.D. Howe Institute, issue 365, October.
For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: (Wendy Shamier).
If references are entirely missing, you can add them using this form.