General Practice: Four Empirical Essays on GP Behaviour and Individuals’ Preferences for GPs

On June 1, 2001 a reform took place in Norwegian general practice. This implied some advantages of importance to empirical analysis. First, a new organisation and a new payment system were introduced, which makes it possible to perform before-after analysis. Second, the GPs' preferred list-sizes are known, which makes it possible to analyse the effect of patient constraints for individual GPs. Third, the size and composition of patient-lists are known on the individual practice level. Previously, it was not known whether consultations provided during a certain period were given to a large or a small number of persons, and this made it difficult to compare practice styles. If, for instance, two GPs provide the same number of services during one year, but GP A is responsible for twice as many patients as GP B, GP B has a more service-intensive practice style. When information on the number of patients on the list is not known, we might erroneously conclude that A and B have the same practice style. Last, but not least, the population filled in an entry form ahead of the nationwide reform - which gives us information on preferences for GPs for the whole population. Report 2004: 1 "General Practice: Four Empirical Essays on GP Behaviour and Individuals Preferences for GPs" focuses on the General Practitioner reform. Four essays show different impacts this reform had on the general practitioners practice and preferences in the population. Summing up the reform in general practice is very well suited for collecting interesting data and doing empirical analysis. The first three analyses in this doctoral thesis by Hilde Lurås are based on the evaluation of the list patient trial (in four municipalities in 1993-1996). The last analysis is based on the evaluation of the nationwide reform in 2001.