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Quality incentives in a regulated market with imperfect information and switching costs: capitation in general practice

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Author Info
Hugh Gravelle
Giuliano Masiero

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Abstract

We model a system akin to the British National Health Service in which general practictioners (GPs) are paid from general taxation. GPs are horizontally and vertically differentiated and compete via their imperfect observed quality. We focus on the way in which patient uncertainty and switching costs interact and the implications for GP's choice of quality. We show that for any given capitation fee quality is lower and the incentive effects of the fee on quality are smaller. There are diminishing welfare gains from improving consumers information but increasing welfare gains from reducing switching costs. GPs do not act efficiently to improve consumer information via advertising or to reduce the costs of switching.

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Paper provided by Department of Economics, University of York in its series Discussion Papers with number 00/18.

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Handle: RePEc:yor:yorken:00/18

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Related research
Keywords: Switching costs Imperfect information Quality Product differentiation Capitation General Practice

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Find related papers by JEL classification:
I1 - Health, Education, and Welfare - - Health
L13 - Industrial Organization - - Market Structure, Firm Strategy, and Market Performance - - - Oligopoly and Other Imperfect Markets

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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. Klemperer, Paul, 1995. "Competition When Consumers Have Switching Costs: An Overview with Applications to Industrial Organization, Macroeconomics, and International Trade," Review of Economic Studies, Blackwell Publishing, vol. 62(4), pages 515-39, October. [Downloadable!] (restricted)
  2. Steven C. Salop, 1979. "Monopolistic Competition with Outside Goods," Bell Journal of Economics, The RAND Corporation, vol. 10(1), pages 141-156, Spring. [Downloadable!] (restricted)
  3. Paul Klemperer, 1987. "The Competitiveness of Markets with Switching Costs," RAND Journal of Economics, The RAND Corporation, vol. 18(1), pages 138-150, Spring. [Downloadable!] (restricted)
  4. Helmut Bester, 1998. "Quality Uncertainty Mitigates Product Differentiation," RAND Journal of Economics, The RAND Corporation, vol. 29(4), pages 828-844, Winter. [Downloadable!] (restricted)
  5. Economides, Nicholas, 1993. "Quality variations in the circular model of variety-differentiated products," Regional Science and Urban Economics, Elsevier, vol. 23(2), pages 235-257, April. [Downloadable!] (restricted)
  6. Schmalensee, Richard, 1982. "Product Differentiation Advantages of Pioneering Brands," American Economic Review, American Economic Association, vol. 72(3), pages 349-65, June. [Downloadable!] (restricted)
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  7. Wolinsky, Asher, 1984. "Product Differentiation with Imperfect Information," Review of Economic Studies, Blackwell Publishing, vol. 51(1), pages 53-61, January. [Downloadable!] (restricted)
  8. Tore Nilssen, 1992. "Two Kinds of Consumer Switching Costs," RAND Journal of Economics, The RAND Corporation, vol. 23(4), pages 579-589, Winter. [Downloadable!] (restricted)
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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. Michele Moretto & Rosella Levaggi, 2004. "Investment in Hospital Care Technology under Different Purchasing Rules: A Real Option Approach," Working Papers 2004.75, Fondazione Eni Enrico Mattei. [Downloadable!]
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  2. M. Lippi Bruni & L. Nobilio & C. Ugolini, 2007. "Economic Incentives in General Practice: the Impact of Pay for Participation Programs on Diabetes Care," Working Papers 607, Dipartimento Scienze Economiche, Università di Bologna. [Downloadable!]
  3. Yasuo Sanjo, 2007. "Hotelling's Location Model with Quality Choice in Mixed Duopoly," Economics Bulletin, Economics Bulletin, vol. 18(2), pages 1-11. [Downloadable!]
  4. Kurt R. Brekke & Robert Nuscheler & Odd Rune Straume, 2005. "Gatekeeping in Health Care," CESifo Working Paper Series CESifo Working Paper No. , CESifo GmbH. [Downloadable!]
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