Additional information is available for the following registered author(s):

• Geir Godager

There are several motivations for studying the market for GPs. GPs play a key role and constitute the cornerstone of the health care sector in Norway and other countries with a national health service. The GP is often a patient's first encounter with the health care sector. In Norway the GP also acts as a “gatekeeper”, and a referral from the GP is necessary in order to receive specialized care. Further, decisions made by GPs have a large impact on public spending such as sick-leave benefits and drug reimbursements. Due to this pivotal role of general practice, any research providing policy guidance for the sector will potentially have noticeable welfare effects.

Studying this market may also provide advances in terms of enhanced understanding of economic behavior in general, and within the discipline of health economics in particular. Arrow's (1963) article describing various imperfections in the market for medical care is often considered to mark the founding of health economics (Culyer and Newhouse, 2000). Many of the peculiarities Arrow describes are, indeed, present in the market for GPs' services. Asymmetric information limits consumer sovereignty and creates challenges for designing appropriate contracts and payment mechanisms. Quality of services is diffcult to observe and quantify, and optimal consumption of health care services is diffcult to achieve. While the general research questions in health economics are relevant in the specific context of general practice, the conditions for knowledge accumulation seem favorable as well. The availability of detailed and disaggregated panel data enables identification and quantification of the mechanisms in focus by applying a large variety of modeling and estimation methods. In addition, one may argue that economic theory is well suited to model individual behavior and that assumptions of rational decision makers are more realistic when describing individuals such as GPs than when describing institutions such as hospitals. Fuchs (2000) describes two related missions of health economists: providing valuable input into health policy and enhancing understanding of economic behavior. Both missions motivate research on the market for GPs.

Essays 1 and 2 in this dissertation focus mainly on factors influencing the patients' or consumers' decision to seek the services of a particular GP, while Essays 3 and 4 focus on factors influencing the GP's supply decision. The rest of the text proceeds as follows: The next subsection provides a brief introduction to the topic of this dissertation. Summaries of the four essays are given in subsection 1.3. Policy implications of the findings are presented in subsection 1.4. Limitations and ideas for future research are discussed in subsection 1.5. Complete versions of Essays 1-4 follow in sections 2-5.

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Paper provided by Oslo University, Health Economics Research Programme in its series HERO On line Working Paper Series with number 2009:7.

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Length: 141 pages
Date of creation: 28 Sep 2009
Date of revision:
Handle: RePEc:hhs:oslohe:2009_007

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Keywords: GP services; discrete choice; willingness-to-pay; health care demand; health care supply; general practice; patient shortage; dual job holding;

Find related papers by JEL classification:
C23 - Mathematical and Quantitative Methods - - Single Equation Models; Single Variables - - - Models with Panel Data
C24 - Mathematical and Quantitative Methods - - Single Equation Models; Single Variables - - - Truncated and Censored Models
C25 - Mathematical and Quantitative Methods - - Single Equation Models; Single Variables - - - Discrete Regression and Qualitative Choice Models
C33 - Mathematical and Quantitative Methods - - Multiple or Simultaneous Equation Models; Multiple Variables - - - Models with Panel Data
C83 - Mathematical and Quantitative Methods - - Data Collection and Data Estimation Methodology; Computer Programs - - - Survey Methods; Sampling Methods
D12 - Microeconomics - - Household Behavior - - - Consumer Economics: Empirical Analysis
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H51 - Public Economics - - National Government Expenditures and Related Policies - - - Government Expenditures and Health
H75 - Public Economics - - State and Local Government; Intergovernmental Relations - - - Health, Education, and Welfare
I11 - Health, Education, and Welfare - - Health - - - Analysis of Health Care Markets
I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health
J22 - Labor and Demographic Economics - - Demand and Supply of Labor - - - Time Allocation and Labor Supply

This paper has been announced in the following NEP Reports:

• NEP-ALL-2009-10-10 (All new papers)
• NEP-DCM-2009-10-10 (Discrete Choice Models)

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This page was last updated on 2009-11-21.