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

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Author Info
Paula González () (Department of Economics, Universidad Pablo de Olavide)

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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 Format: application/pdf
File Function: First version, 2006
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Publisher Info
Paper provided by Universidad Pablo de Olavide, Departamento de Economía in its series Working Papers with number 06.09.

Download reference. The following formats are available: HTML, plain text, BibTeX, RIS (EndNote), ReDIF
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.

Find related papers by JEL classification:
D82 - Microeconomics - - Information, Knowledge, and Uncertainty - - - Asymmetric and Private Information
H51 - Public Economics - - National Government Expenditures and Related Policies - - - Government Expenditures and Health
I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health
L51 - Industrial Organization - - Regulation and Industrial Policy - - - Economics of Regulation

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References listed on IDEAS
Please report citation or reference errors to , or , if you are the registered author of the cited work, log in to your RePEc Author Service profile, click on "citations" and make appropriate adjustments.:
  1. 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. [Downloadable!] (restricted)
  2. Kurt R. Brekke & Robert Nuscheler & Odd Rune Straume, 2005. "Gatekeeping in Health Care," CESifo Working Paper Series CESifo Working Paper No. , CESifo GmbH. [Downloadable!]
    Other versions:
  3. 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. [Downloadable!] (restricted)
  4. Paula González, 2004. "Should physicians' dual practice be limited? An incentive approach," Health Economics, John Wiley & Sons, Ltd., vol. 13(6), pages 505-524. [Downloadable!]
  5. James M. Malcomson, 2004. "Health Service Gatekeepers," RAND Journal of Economics, The RAND Corporation, vol. 35(2), pages 401-421, Summer.
    Other versions:
  6. Izabela Jelovac, 2001. "Physicians' payment contracts, treatment decisions and diagnosis accuracy," Health Economics, John Wiley & Sons, Ltd., vol. 10(1), pages 9-25.
  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. [Downloadable!] (restricted)
  8. Erik Schokkaert & Carine Van de Voorde, 2005. "Health care reform in Belgium," Health Economics, John Wiley & Sons, Ltd., vol. 14(S1), pages S25-S39. [Downloadable!]
Full references

Cited by:
(explanations, Please report citation or reference errors to , or , if you are the registered author of the cited work, log in to your RePEc Author Service profile, click on "citations" and make appropriate adjustments.)

  1. Kurt R. Brekke & Robert Nuscheler & Odd Rune Straume, 2005. "Gatekeeping in Health Care," CESifo Working Paper Series CESifo Working Paper No. , CESifo GmbH. [Downloadable!]
    Other versions:
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