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The Gatekeeping Role of General Practitioners. Does Patients' Information Matter?

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  • Paula González

    ()
    (Department of Economics, Universidad Pablo de Olavide)

Abstract

We develop a principal-agent model in which the health authority acts as a principal for both a patient and a general practitioner (GP). The goal of the paper is to investigate the relative merits of gatekeeping and non-gatekeeping systems and to analyze the role of the quality of patient information and referral pressure in determining which model dominates. We find that, whenever GPs incentives matter, non-gatekeeping is better only if there is a sufficiently high pressure for referral. At the same time, for a non-gatekeeping system to dominate, the quality of the patient information should not be extreme: neither too bad (patient’ s self-referral would be very inefficient) nor too good (the GP’s agency problem would be very costly).

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File URL: http://www.upo.es/serv/bib/wps/econ0609.pdf
File Function: First version, 2006
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Bibliographic Info

Paper provided by Universidad Pablo de Olavide, Department of Economics in its series Working Papers with number 06.09.

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Length: 31 pages
Date of creation: Mar 2006
Date of revision:
Handle: RePEc:pab:wpaper:06.09

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Related research

Keywords: General Practice; Moral hazard; Incentives; Patients’ beliefs; Patients’ pressure; Referrals.;

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References

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  1. Kurt R. Brekke & Robert Nuscheler & Odd Rune Straume, 2005. "Gatekeeping in Health Care," CESifo Working Paper Series 1552, CESifo Group Munich.
  2. Izabela Jelovac, 2001. "Physicians' payment contracts, treatment decisions and diagnosis accuracy," Health Economics, John Wiley & Sons, Ltd., vol. 10(1), pages 9-25.
  3. Paula González, 2004. "Should physicians' dual practice be limited? An incentive approach," Health Economics, John Wiley & Sons, Ltd., vol. 13(6), pages 505-524.
  4. Croxson, B. & Propper, C. & Perkins, A., 2001. "Do doctors respond to financial incentives? UK family doctors and the GP fundholder scheme," Journal of Public Economics, Elsevier, vol. 79(2), pages 375-398, February.
  5. Iversen, Tor & Luras, Hilde, 2000. "Economic motives and professional norms: the case of general medical practice," Journal of Economic Behavior & Organization, Elsevier, vol. 43(4), pages 447-470, December.
  6. Erik Schokkaert & Carine Van de Voorde, 2005. "Health care reform in Belgium," Health Economics, John Wiley & Sons, Ltd., vol. 14(S1), pages S25-S39.
  7. Marinoso, Begona Garcia & Jelovac, Izabela, 2003. "GPs' payment contracts and their referral practice," Journal of Health Economics, Elsevier, vol. 22(4), pages 617-635, July.
  8. Scott, Anthony, 2000. "Economics of general practice," Handbook of Health Economics, in: A. J. Culyer & J. P. Newhouse (ed.), Handbook of Health Economics, edition 1, volume 1, chapter 22, pages 1175-1200 Elsevier.
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Cited by:
  1. Iversen, Tor & Ma, Albert, 2009. "Market Conditions and General Practitioners’ Referrals," HERO On line Working Paper Series 2009:8, Oslo University, Health Economics Research Programme.
  2. Brekke, Kurt R. & Nuscheler, Robert & Straume, Odd Rune, 2007. "Gatekeeping in health care," Journal of Health Economics, Elsevier, vol. 26(1), pages 149-170, January.

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