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On a policy of transferring public patients to private practice

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  • Paula González

Abstract

We consider an economy where public hospitals are capacity‐constrained, and we analyse the willingness of health authorities to reach agreements with private hospitals to have some of their patients treated there. When physicians are dual suppliers, we show that a problem of cream‐skimming arises and reduces the incentives of the health authority to undertake such a policy. We argue that the more dispersed are the severities of the patients, the greater the reduction in the incentives will be. We also show that, despite the patient selection problem, when the policy is implemented it is often the case that health authorities decide a more intensive transfer of patients to private practice. Copyright © 2004 John Wiley & Sons, Ltd.

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  • Paula González, 2005. "On a policy of transferring public patients to private practice," Health Economics, John Wiley & Sons, Ltd., vol. 14(5), pages 513-527, May.
    • Handle: RePEc:wly:hlthec:v:14:y:2005:i:5:p:513-527
    DOI: 10.1002/hec.946
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    1. Propper, Carol, 1995. "Agency and incentives in the NHS internal market," Social Science & Medicine, Elsevier, vol. 40(12), pages 1683-1690, June.
    2. Hoel, Michael & Saether, Erik Magnus, 2003. "Public health care with waiting time: the role of supplementary private health care," Journal of Health Economics, Elsevier, vol. 22(4), pages 599-616, July.
    3. Boadway, Robin & Marchand, Maurice & Sato, Motohiro, 2004. "An optimal contract approach to hospital financing," Journal of Health Economics, Elsevier, vol. 23(1), pages 85-110, January.
    4. David Dranove, 1987. "Rate-Setting by Diagnosis Related Groups and Hospital Specialization," RAND Journal of Economics, The RAND Corporation, vol. 18(3), pages 417-427, Autumn.
    5. Ma, Ching-to Albert, 1994. "Health Care Payment Systems: Cost and Quality Incentives," Journal of Economics & Management Strategy, Wiley Blackwell, vol. 3(1), pages 93-112, Spring.
    6. Ellis, Randall P. & McGuire, Thomas G., 1990. "Optimal payment systems for health services," Journal of Health Economics, Elsevier, vol. 9(4), pages 375-396, December.
    7. Neil Rickman & Alistair McGuire, 1999. "Regulating Providers’ Reimbursement in a Mixed Market for Health Care," Scottish Journal of Political Economy, Scottish Economic Society, vol. 46(1), pages 53-71, February.
    8. Paula González, 2004. "Should physicians' dual practice be limited? An incentive approach," Health Economics, John Wiley & Sons, Ltd., vol. 13(6), pages 505-524, June.
    9. Blomqvist, Ake, 1991. "The doctor as double agent: Information asymmetry, health insurance, and medical care," Journal of Health Economics, Elsevier, vol. 10(4), pages 411-432.
    10. Cullis, John G. & Jones, Philip R., 1985. "National health service waiting lists : A discussion of competing explanations and a policy proposal," Journal of Health Economics, Elsevier, vol. 4(2), pages 119-135, June.
    11. Iversen, Tor, 1997. "The effect of a private sector on the waiting time in a national health service," Journal of Health Economics, Elsevier, vol. 16(4), pages 381-396, August.
    12. Olivella, Pau, 2003. "Shifting public-health-sector waiting lists to the private sector," European Journal of Political Economy, Elsevier, vol. 19(1), pages 103-132, March.
    13. Ellis, Randall P., 1998. "Creaming, skimping and dumping: provider competition on the intensive and extensive margins1," Journal of Health Economics, Elsevier, vol. 17(5), pages 537-555, October.
    14. Ellis, Randall P. & McGuire, Thomas G., 1986. "Provider behavior under prospective reimbursement : Cost sharing and supply," Journal of Health Economics, Elsevier, vol. 5(2), pages 129-151, June.
    15. Selden, Thomas M., 1990. "A model of capitation," Journal of Health Economics, Elsevier, vol. 9(4), pages 397-409, December.
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    Cited by:

    1. Barış Alpaslan & King Yoong Lim & Yan Song, 2021. "Growth and welfare in mixed health system financing with physician dual practice in a developing economy: a case of Indonesia," International Journal of Health Economics and Management, Springer, vol. 21(1), pages 51-80, March.
    2. Dixon, Huw & Siciliani, Luigi, 2009. "Waiting-time targets in the healthcare sector: How long are we waiting?," Journal of Health Economics, Elsevier, vol. 28(6), pages 1081-1098, December.
    3. González, Paula & Macho-Stadler, Inés, 2013. "A theoretical approach to dual practice regulations in the health sector," Journal of Health Economics, Elsevier, vol. 32(1), pages 66-87.
    4. Gacevic, Marijana & Santric Milicevic, Milena & Vasic, Milena & Horozovic, Vesna & Milicevic, Marko & Milic, Natasa, 2018. "The relationship between dual practice, intention to work abroad and job satisfaction: A population-based study in the Serbian public healthcare sector," Health Policy, Elsevier, vol. 122(10), pages 1132-1139.
    5. Socha, Karolina & Bech, Mickael, 2011. "The relationship between dual practice and physicians’ work behaviour in the public hospitals: Results from the Danish survey," DaCHE discussion papers 2011:1, University of Southern Denmark, Dache - Danish Centre for Health Economics.
    6. Obrizan, Maksym, 2019. "Diverging trends in health care use between 2010 and 2016: Evidence from three groups of transition countries," Economic Systems, Elsevier, vol. 43(1), pages 19-29.
    7. Garcia-Prado, Ariadna & Gonzalez, Paula, 2007. "Policy and regulatory responses to dual practice in the health sector," Health Policy, Elsevier, vol. 84(2-3), pages 142-152, December.
    8. Qian, Qu & Zhuang, Weifen, 2017. "Tax/subsidy and capacity decisions in a two-tier health system with welfare redistributive objective," European Journal of Operational Research, Elsevier, vol. 260(1), pages 140-151.
    9. Socha, Karolina, 2010. "Physician dual practice and the public health care provision. Review of the literature," DaCHE discussion papers 2010:4, University of Southern Denmark, Dache - Danish Centre for Health Economics.
    10. Cheng, Terence C. & Haisken-DeNew, John P. & Yong, Jongsay, 2015. "Cream skimming and hospital transfers in a mixed public-private system," Social Science & Medicine, Elsevier, vol. 132(C), pages 156-164.
    11. Siciliani, Luigi, 2006. "Selection of treatment under prospective payment systems in the hospital sector," Journal of Health Economics, Elsevier, vol. 25(3), pages 479-499, May.
    12. Socha, Karolina Z. & Bech, Mickael, 2011. "Physician dual practice: A review of literature," Health Policy, Elsevier, vol. 102(1), pages 1-7, September.

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