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Competition in general practice: Prescriptions to the elderly in a list patient system

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  • Kann, Inger Cathrine
  • Biørn, Erik
  • Lurås, Hilde

Abstract

Income motivation among general practitioners (GPs) is frequently discussed in the health economics literature. The question addressed in the present study on reimbursement drugs and addictive drugs is whether increased competition among GPs, which is part of a declared health policy to improve efficiency, contributes to more prescriptions for the elderly. The dataset comprises registered data of all prescribed drugs dispensed at pharmacies from the Norwegian Prescription Database merged with data on GPs. In choosing a method, particular attention is given to the fact that patients tend to be attracted to GPs who fit their preferences. Hence, we treat the composition of the patient list as endogenous. The results indicate that the stronger competition a GP faces, the more drugs are prescribed, which implies that GPs' prescription style may conflict with their role as gatekeepers, and even worse, it may be a hazard to patients' health.

Suggested Citation

  • Kann, Inger Cathrine & Biørn, Erik & Lurås, Hilde, 2010. "Competition in general practice: Prescriptions to the elderly in a list patient system," Journal of Health Economics, Elsevier, vol. 29(5), pages 751-764, September.
  • Handle: RePEc:eee:jhecon:v:29:y:2010:i:5:p:751-764
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    References listed on IDEAS

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    1. Carlsen, Benedicte & Nyborg, Karine, 2009. "The Gate is Open: Primary Care Physicians as Social Security Gatekeepers," Memorandum 07/2009, Oslo University, Department of Economics.
    2. Anthony Scott & Alan Shiell, 1997. "Analysing the effect of competition on General Practitioners' behaviour using a multilevel modelling framework," Health Economics, John Wiley & Sons, Ltd., vol. 6(6), pages 577-588.
    3. 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.
    4. Blomqvist, Ake, 1991. "The doctor as double agent: Information asymmetry, health insurance, and medical care," Journal of Health Economics, Elsevier, vol. 10(4), pages 411-432.
    5. Darby, Michael R & Karni, Edi, 1973. "Free Competition and the Optimal Amount of Fraud," Journal of Law and Economics, University of Chicago Press, vol. 16(1), pages 67-88, April.
    6. Hausman, Jerry A & Taylor, William E, 1981. "Panel Data and Unobservable Individual Effects," Econometrica, Econometric Society, vol. 49(6), pages 1377-1398, November.
    7. McGuire, Thomas G., 2000. "Physician agency," Handbook of Health Economics,in: A. J. Culyer & J. P. Newhouse (ed.), Handbook of Health Economics, edition 1, volume 1, chapter 9, pages 461-536 Elsevier.
    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.
    9. Geir Godager & Tor Iversen & Ching-To Ma, 2009. "Service motives and profit incentives among physicians," International Journal of Health Economics and Management, Springer, vol. 9(1), pages 39-57, March.
    10. Grytten, Jostein & Sørensen, Rune, 2008. "Busy physicians," Journal of Health Economics, Elsevier, vol. 27(2), pages 510-518, March.
    11. Iversen, Tor, 2004. "The effects of a patient shortage on general practitioners' future income and list of patients," Journal of Health Economics, Elsevier, vol. 23(4), pages 673-694, July.
    12. Breusch, Trevor S & Mizon, Grayham E & Schmidt, Peter, 1989. "Efficient Estimation Using Panel Data," Econometrica, Econometric Society, vol. 57(3), pages 695-700, May.
    13. Iversen, Tor & Lurås, Hilde, 2009. "The importance of micro-data for revaealing income motivated behaviour among GPs," HERO On line Working Paper Series 1999:3, Oslo University, Health Economics Research Programme.
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    Cited by:

    1. Tor Iversen & Hilde Lurås, 2012. "Capitation and Incentives in Primary Care," Chapters,in: The Elgar Companion to Health Economics, Second Edition, chapter 26 Edward Elgar Publishing.
    2. Iezzi, Elisa & Lippi Bruni, Matteo & Ugolini, Cristina, 2014. "The role of GP's compensation schemes in diabetes care: Evidence from panel data," Journal of Health Economics, Elsevier, vol. 34(C), pages 104-120.
    3. Fiorentini, Gianluca & Lippi Bruni, Matteo & Ugolini, Cristina, 2013. "GPs and hospital expenditures. Should we keep expenditure containment programs alive?," Social Science & Medicine, Elsevier, vol. 82(C), pages 10-20.
    4. Dietrichson, Jens & Ellegård, Lina Maria & Kjellsson, Gustav, 2016. "Effects of Increased Competition on Quality of Primary Care in Sweden," Working Papers 2016:36, Lund University, Department of Economics.
    5. Bourke, Jane & Roper, Stephen, 2014. "The influence of experiential learning on medical equipment adoption in general practices," Health Policy, Elsevier, vol. 118(1), pages 37-47.
    6. Choné, P. & Coudin, É. & Pla, A., 2014. "Are physician fees responsive to competition?," Health, Econometrics and Data Group (HEDG) Working Papers 14/20, HEDG, c/o Department of Economics, University of York.
    7. Iversen, Tor & Lurås, Hilde, 2011. "Patient switching in general practice," Journal of Health Economics, Elsevier, vol. 30(5), pages 894-903.
    8. Jane Bourke & Stephen Roper, 2012. "In with the new: the determinants of prescribing innovation by general practitioners in Ireland," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 13(4), pages 393-407, August.

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