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Does prescribing appropriateness reduce health expenditures? Main effects and unintended outcomes

Author

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  • Claudio Lucifora

    (Università Cattolica del Sacro Cuore
    Dipartimento di Economia e Finanza, Università Cattolica del Sacro Cuore)

  • Antonio Russo
  • Daria Vigani

    (Università Cattolica del Sacro Cuore
    Dipartimento di Economia e Finanza, Università Cattolica del Sacro Cuore)

Abstract

We evaluate the effectiveness of a reform to contain health-care costs by restraining general practitioners' (GP) ability to prescribe outpatient treatments, on the basis of strict appropriateness criteria. Using register data for a large Metropolitan area in Italy, we find a significant contraction in both outpatient expenditures (-24%) and volumes (-12%) after the reform. The effects on expenditures are found to be heterogeneous across GPs' characteristics, pointing out the mediating role of GPs' prescribing behavior. The reform also affected the composition of outpatient spending and produced unintended consequences on the demand for medical services of vulnerable groups, who were originally excluded from its application, as well as on access to emergency care.

Suggested Citation

  • Claudio Lucifora & Antonio Russo & Daria Vigani, 2021. "Does prescribing appropriateness reduce health expenditures? Main effects and unintended outcomes," DISCE - Working Papers del Dipartimento di Economia e Finanza def103, Università Cattolica del Sacro Cuore, Dipartimenti e Istituti di Scienze Economiche (DISCE).
    • Handle: RePEc:ctc:serie1:def103
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    Cited by:

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    2. Boitani, Andrea & Dragomirescu-Gaina, Catalin, 2023. "News and narratives: A cointegration analysis of Russian economic policy uncertainty," Economics Letters, Elsevier, vol. 226(C).
    3. Russell Davidson & Andrea Monticini, 2023. "Bootstrap Performance with Heteroskedasticity," DISCE - Working Papers del Dipartimento di Economia e Finanza def130, Università Cattolica del Sacro Cuore, Dipartimenti e Istituti di Scienze Economiche (DISCE).
    4. Luca Armanaschi & Elisabetta Barzan & Magda Cavallucci & Carlo Federici & Marco Sartirana & Florian Zerzer, 2022. "I dati amministrativi per la governance dei tempi di attesa delle prestazioni ambulatoriali: l?esperienza dell?Azienda Sanitaria dell?Alto Adige," MECOSAN, FrancoAngeli Editore, vol. 2022(123), pages 53-75.
    5. Valentina Colombo & Alessia Paccagnini, 2024. "Uncertainty and the Federal Reserve’s Balance Sheet Monetary Policy," DISCE - Working Papers del Dipartimento di Economia e Finanza def131, Università Cattolica del Sacro Cuore, Dipartimenti e Istituti di Scienze Economiche (DISCE).
    6. Checchi, Daniele & Fenizia, Alessandra & Lucifora, Claudio, 2021. "Public Sector Jobs: Working in the Public Sector in Europe and the US," IZA Discussion Papers 14514, Institute of Labor Economics (IZA).
    7. Basiglio Stefania & Foresta Alessandra & Turati Gilberto, 2021. "Impatience and crime. Evidence from the NLSY97," Working papers 073, Department of Economics and Statistics (Dipartimento di Scienze Economico-Sociali e Matematico-Statistiche), University of Torino.
    8. Irene Torrini & Claudio Lucifora & Antonio Russo, 2022. "The Long-Term Effects of Hospitalization on Health Care Expenditures: An Empirical Analysis for the Young-Old Population," DISCE - Working Papers del Dipartimento di Economia e Finanza def117, Università Cattolica del Sacro Cuore, Dipartimenti e Istituti di Scienze Economiche (DISCE).

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    More about this item

    Keywords

    Prescribing appropriateness; Health-care expenditures; Primary care.;
    All these keywords.

    JEL classification:

    • H51 - Public Economics - - National Government Expenditures and Related Policies - - - Government Expenditures and Health
    • I38 - Health, Education, and Welfare - - Welfare, Well-Being, and Poverty - - - Government Programs; Provision and Effects of Welfare Programs
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health

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