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Does quality influence choice of general practitioner? An analysis of matched doctor-patient panel data

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  • Biørn, Erik
  • Godager, Geir

Abstract

The impact of quality on the demand facing health care providers has important implications for the industrial organization of health care markets. In this paper we study the consumers' choice of general practitioner (GP), assuming they are unable to observe the true quality of GP services. A panel data set for 484 Norwegian GPs, with summary information on their patient stocks, renders the opportunity to identify and measure the impact of GP quality on the demand, accounting for patient health heterogeneity. We apply a multi-equation model in the LISREL format, with GP quality and patient health as latent determinants of demand for GP services. Patient excess mortality rate at the GP level is one indicator of quality. Our results indicate that GP quality has a clear positive effect on demand, even when patient heterogeneity is accounted for.

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  • Biørn, Erik & Godager, Geir, 2010. "Does quality influence choice of general practitioner? An analysis of matched doctor-patient panel data," Economic Modelling, Elsevier, vol. 27(4), pages 842-853, July.
    • Handle: RePEc:eee:ecmode:v:27:y:2010:i:4:p:842-853
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    Cited by:

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    2. Nilsen, Øivind Anti & Raknerud, Arvid & Skjerpen, Terje, 2011. "Using the Helmert-transformation to reduce dimensionality in a mixed model: Application to a wage equation with worker and firm heterogeneity," Discussion Paper Series in Economics 11/2011, Norwegian School of Economics, Department of Economics, revised 04 Oct 2011.
    3. Rita Santos & Hugh Gravelle & Carol Propper, 2013. "Does quality affect patients’ choice of doctor? Evidence from the UK," The Centre for Market and Public Organisation 13/306, The Centre for Market and Public Organisation, University of Bristol, UK.
    4. Visa Pitkänen & Ismo Linnosmaa, 2021. "Choice, quality and patients’ experience: evidence from a Finnish physiotherapy service," International Journal of Health Economics and Management, Springer, vol. 21(2), pages 229-245, June.
    5. Jeannette Brosig‐Koch & Burkhard Hehenkamp & Johanna Kokot, 2017. "The effects of competition on medical service provision," Health Economics, John Wiley & Sons, Ltd., vol. 26(S3), pages 6-20, December.
    6. Anell, Anders & Dietrichson, Jens & Ellegård, Lina Maria & Kjellsson, Gustav, 2021. "Information, switching costs, and consumer choice: Evidence from two randomised field experiments in Swedish primary health care," Journal of Public Economics, Elsevier, vol. 196(C).
    7. Schaumans, Catherine, 2015. "Prescribing behavior of General Practitioners: Competition matters," Health Policy, Elsevier, vol. 119(4), pages 456-463.
    8. Godager , Geir & Scott, Anthony, 2023. "Physician Behavior and Health Outcomes," HERO Online Working Paper Series 2023:3, University of Oslo, Health Economics Research Programme.
    9. Alexander Ahammer & Ivan Zilic, 2017. "Do Financial Incentives Alter Physician Prescription Behavior? Evidence from Random Patient-GP Allocations," Working Papers 1701, The Institute of Economics, Zagreb.
    10. Dahlgren, Cecilia & Dackehag, Margareta & Wändell, Per & Rehnberg, Clas, 2021. "Simply the best? The impact of quality on choice of primary healthcare provider in Sweden," Health Policy, Elsevier, vol. 125(11), pages 1448-1454.
    11. Soheil Davari & Kemal Kilic & Gurdal Ertek, 2015. "Fuzzy bi-objective preventive health care network design," Health Care Management Science, Springer, vol. 18(3), pages 303-317, September.
    12. Rita Santos & Hugh Gravelle & Carol Propper, 2013. "Does quality affect patients’ choice of doctor? Evidence from the UK," Working Papers 088cherp, Centre for Health Economics, University of York.
    13. Simen Markussen, 2012. "The individual cost of sick leave," Journal of Population Economics, Springer;European Society for Population Economics, vol. 25(4), pages 1287-1306, October.
    14. Biørn, Erik & Godager, Geir, 2010. "Does quality influence choice of general practitioner? An analysis of matched doctor-patient panel data," Economic Modelling, Elsevier, vol. 27(4), pages 842-853, July.
    15. Empel, Giovanni & Gravelle, Hugh & Santos, Rita, 2023. "Does quality affect choice of family physician? Evidence from patients changing general practice without changing address," Economic Modelling, Elsevier, vol. 126(C).
    16. Schaumans, C.B.C., 2014. "Prescribing Behavior of General Practitioners : Competition Matters!," Other publications TiSEM 6d0d2ee7-fe03-41c3-89bc-8, Tilburg University, School of Economics and Management.
    17. Anell, Anders & Dackehag, Margareta & Dietrichson, Jens & Ellegård, Lina Maria & Kjellsson, Gustav, 2022. "Better Off by Risk Adjustment? Socioeconomic Disparities in Care Utilization in Sweden Following a Payment Reform," Working Papers 2022:15, Lund University, Department of Economics, revised 12 Mar 2024.
    18. Epstein, D.S. & Barton, C. & Mazza, D. & Woode, M.E. & Mortimer, D., 2020. "Patient chosen gap payments in primary care: Predictions of patient acceptability, uptake and willingness to pay from a discrete choice experiment," Social Science & Medicine, Elsevier, vol. 263(C).
    19. Øivind A. Nilsen & Arvid Raknerud & Terje Skjerpen, 2017. "Estimation of a model for matched panel data with high-dimensional two-way unobserved heterogeneity," Empirical Economics, Springer, vol. 53(4), pages 1657-1680, December.
    20. Iversen, Tor & Lurås, Hilde, 2011. "Patient switching in general practice," Journal of Health Economics, Elsevier, vol. 30(5), pages 894-903.
    21. Schaumans, C.B.C., 2014. "Prescribing Behavior of General Practitioners : Competition Matters!," Other publications TiSEM c8445d1f-66f8-4238-835e-d, Tilburg University, School of Economics and Management.

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    More about this item

    Keywords

    GP services Health care quality Health care demand Latent variables LISREL model Panel data Norway;

    JEL classification:

    • I11 - Health, Education, and Welfare - - Health - - - Analysis of Health Care Markets
    • H51 - Public Economics - - National Government Expenditures and Related Policies - - - Government Expenditures and Health
    • C23 - Mathematical and Quantitative Methods - - Single Equation Models; Single Variables - - - Models with Panel Data; Spatio-temporal Models
    • H75 - Public Economics - - State and Local Government; Intergovernmental Relations - - - State and Local Government: Health, Education, and Welfare
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health
    • D83 - Microeconomics - - Information, Knowledge, and Uncertainty - - - Search; Learning; Information and Knowledge; Communication; Belief; Unawareness
    • C33 - Mathematical and Quantitative Methods - - Multiple or Simultaneous Equation Models; Multiple Variables - - - Models with Panel Data; Spatio-temporal Models

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