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Choice in the presence of experts: the role of general practitioners in patients' hospital choice

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  • Walter Beckert

    (Institute for Fiscal Studies and Birkbeck, University of London)

  • Kate Collyer

    (Institute for Fiscal Studies)

Abstract

This paper considers the micro-econometric analysis of patients' hospital choice for elective medical procedures when their choice set is pre-selected by a general practitioner (GP). It proposes a two-stage choice model that encompasses both, patient and GP level optimization, and it discusses identifi cation. The empirical analysis demonstrates biases and inconsistencies that arise when strategic pre-selection is not properly taken into account. We fi nd that patients defer to GPs when assessing hospital quality and focus on tangible attributes, like hospital amenities; and that GPs, in turn, as patients' agents present choice options based on quality, but as agents of health authorities also consider their financial implications.

Suggested Citation

  • Walter Beckert & Kate Collyer, 2016. "Choice in the presence of experts: the role of general practitioners in patients' hospital choice," IFS Working Papers W16/21, Institute for Fiscal Studies.
    • Handle: RePEc:ifs:ifsewp:16/21
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    Blog mentions

    As found by EconAcademics.org, the blog aggregator for Economics research:
    1. Chris Sampson’s journal round-up for 2nd July 2018
      by Chris Sampson in The Academic Health Economists' Blog on 2018-07-02 11:00:43

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    Cited by:

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    2. Charlotte Davies, 2020. "The supply side to procurement in a health market: competition and innovation in hip implants," Working Paper series, University of East Anglia, Centre for Competition Policy (CCP) 2020-01, Centre for Competition Policy, University of East Anglia, Norwich, UK..
    3. Davies, Charlotte & Davies, Stephen, 2021. "Assessing competition in the hip implant industry in the light of recent policy guidance," Social Science & Medicine, Elsevier, vol. 287(C).
    4. Chen, Qiulin & Xu, Duo & Fu, Hongqiao & Yip, Winnie, 2022. "Distance effects and home bias in patient choice on the Internet: Evidence from an online healthcare platform in China," China Economic Review, Elsevier, vol. 72(C).
    5. Zhang, Mengdan & Zhang, Chonghui & Shi, Qiule & Zeng, Shouzhen & Balezentis, Tomas, 2022. "Operationalizing the telemedicine platforms through the social network knowledge: An MCDM model based on the CIPFOHW operator," Technological Forecasting and Social Change, Elsevier, vol. 174(C).
    6. Giuseppe Moscelli & Hugh Gravelle & Luigi Siciliani, 2021. "Hospital competition and quality for non‐emergency patients in the English NHS," RAND Journal of Economics, RAND Corporation, vol. 52(2), pages 382-414, June.
    7. Soetevent, Adriaan R., 2021. "I’d Like to Move It! Consumption Rivalry in the EV Public Charging Market: Demand Estimation with Deterministic Choice Set Variation," EconStor Preprints 228520, ZBW - Leibniz Information Centre for Economics.
    8. Devesh Raval & Ted Rosenbaum & Nathan E. Wilson, 2022. "Using disaster‐induced closures to evaluate discrete choice models of hospital demand," RAND Journal of Economics, RAND Corporation, vol. 53(3), pages 561-589, September.
    9. Devesh Raval & Ted Rosenbaum, 2021. "Why is Distance Important for Hospital Choice? Separating Home Bias From Transport Costs," Journal of Industrial Economics, Wiley Blackwell, vol. 69(2), pages 338-368, June.

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    More about this item

    Keywords

    Discrete choice; patient; principal; GP; agent; expert; endogenous choice sets; competition; hospital choice; elective medical procedure.;
    All these keywords.

    JEL classification:

    • D12 - Microeconomics - - Household Behavior - - - Consumer Economics: Empirical Analysis
    • C51 - Mathematical and Quantitative Methods - - Econometric Modeling - - - Model Construction and Estimation
    • I11 - Health, Education, and Welfare - - Health - - - Analysis of Health Care Markets
    • G11 - Financial Economics - - General Financial Markets - - - Portfolio Choice; Investment Decisions

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