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Gatekeeping in health care

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  • Brekke, Kurt R.

    ()
    (University of Bergen, Department of Economics, HEB)

  • Nuscheler, Robert

    ()
    (Wissenschaftszentrum Berlin für Sozialforschung (WZB))

Abstract

We study the competitive effects of restricting direct access to secondary care by gatekeeping, focusing on the informational role of gatekeeping general practitioners (GPs). We consider a secondary care market with two hospitals choosing the quality and specialisation of their care. GPs perfectly observe the diagnosis of a patient and the exact characteristics of the secondary care market. Patients are either informed or uninformed when accessing the hospital market. We consider two distinct cases: first, we let the fraction of informed patients be exogenous, implying that the regulator can only influence patients' decision of consulting a GP by making this compulsory ('direct gatekeeping'). Second, we endogenise this fraction by assuming GP consultation to be costly for the patient. Then the reulator can influence the GP attendance rate through the regulated price ('indirect gatekeeping'). A main finding of the paper is that strict gatekeeping may not be socially desirable, even if it is costless.

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Bibliographic Info

Paper provided by University of Bergen, Department of Economics in its series Working Papers in Economics with number 10/03.

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Length: 28 pages
Date of creation: 04 Jul 2003
Date of revision:
Handle: RePEc:hhs:bergec:2003_010

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Postal: Institutt for økonomi, Universitetet i Bergen, Postboks 7802, 5020 Bergen, Norway
Phone: (+47)55589200
Fax: (+47)55589210
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Web page: http://www.uib.no/econ/en
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Keywords: Gatekeeping; Imperfect information; Quality competition; Product differentiation; Price regulation;

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References

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