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. À l'aide d'un modèle théorique dans lequel patients et médecins doivent choisir la quantité de service à utiliser ainsi que celui, de l'omnipraticien ou du spécialiste uvrant à l'hôpital, qui fournira ces services, nous analysons différents mécanismes d'incitation agissant sur l'offre et la demande. Nous étudions essentiellement deux modes d'organisation : le système conventionnel de rémunération à l'acte et le système de gestion intégrée des soins avec une rémunération per capita; à la fois en présence et en l'absence d'asymétrie d'information. Nous obtenons comme résultat qu'à certaines conditions plausibles, l'optimum de second-rang auquel mène le système de gestion intégrée est supérieur à celui que donne le système conventionnel de rémunération à l'acte qui répercute une partie des coûts sur l'utilisateur.
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Bibliographic InfoPaper provided by CIRANO in its series CIRANO Working Papers with number 2002s-06.
Date of creation: 01 Jan 2002
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Primary Care; Specialty Care; Hospitalization; Insurance; HMOs; Capitation; Asymmetric Information; Omnipraticiens; Spécialistes; Hospitalisation; Assurance; Paiements à l'acte et per capita; Asymétrie d'information;
Other versions of this item:
- Blomqvist, Ake & Leger, Pierre Thomas, 2005. "Information asymmetry, insurance, and the decision to hospitalize," Journal of Health Economics, Elsevier, vol. 24(4), pages 775-793, July.
- 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
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