Modelling the behaviour of general practitioners: a theoretical foundation for studies of fundholding
AbstractDespite its potentially profound repercussions, the general practitioner fundholding scheme has received relatively little attention from researchers. We provide here a theoretical foundation for empirical studies of fundholding. We begin by reviewing the incentives of the fundholding scheme. The responses of GPs to these incentives depend on the objectives of GPs, raising the questions: what are GPs trying to maximise? What GP objectives are useful in explaining their behaviour? After addressing these questions, we formulate several models of behaviour, focusing in turn on referrals, prescribing, workload and the agency relationship between the GP and the patient. These models illustrate how we can provide a conceptual basis for researching various aspects of fundholding. Modelling GP behaviour yields several benefits: it induces us to explicitly identify our assumptions; it illuminates the interactions between incentives and GP objectives; and it can suggest interesting empirical questions. Studies based on such explicit analytical frameworks can elucidate how GPs respond to the incentives of the fundholding scheme.
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.
Bibliographic InfoPaper provided by Centre for Health Economics, University of York in its series Working Papers with number 116chedp.
Length: 44 pages
Date of creation: Mar 1994
Date of revision:
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.:
- Woodward, Robert S. & Warren-Boulton, Frederick, 1984. "Considering the effects of financial incentives and professional ethics on `appropriate' medical care," Journal of Health Economics, Elsevier, vol. 3(3), pages 223-237, December.
- Reinhardt, Uwe E., 1985. "The theory of physician-induced demand reflections after a decade," Journal of Health Economics, Elsevier, vol. 4(2), pages 187-193, June.
- Calnan, Michael & Butler, J. R., 1988. "The economy of time in general practice: An assessment of the influence of list size," Social Science & Medicine, Elsevier, vol. 26(4), pages 435-441, January.
- 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.
- Groenewegen, Peter P. & Hutten, Jank B. F., 1991. "Workload and job satisfaction among general practitioners: A review of the literature," Social Science & Medicine, Elsevier, vol. 32(10), pages 1111-1119, January.
- Dranove, David, 1988. "Demand Inducement and the Physician/Patient Relationship," Economic Inquiry, Western Economic Association International, vol. 26(2), pages 281-98, April.
- Phelps, Charles E., 1986. "Induced demand -- can we ever know its extent?," Journal of Health Economics, Elsevier, vol. 5(4), pages 355-365, December.
For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: (Frances Sharp).
If references are entirely missing, you can add them using this form.