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Do expert patients get better treatment than others? Agency discrimination and statistical discrimination in obstetrics


  • Grytten, Jostein
  • Skau, Irene
  • Sørensen, Rune


We address models that can explain why expert patients (obstetricians, midwives and doctors) are treated better than non-experts (mainly non-medical training). Models of statistical discrimination show that benevolent doctors treat expert patients better, since experts are better at communicating with the doctor. Agency theory suggests that doctors have an incentive to limit hospital costs by distorting information to non-expert patients, but not to expert patients. The hypotheses were tested on a large set of data, which contained information about the highest education of the parents, and detailed medical information about all births in Norway during the period 1967-2005 (Medical Birth Registry). The empirical analyses show that expert parents have a higher rate of Caesarean section than non-expert parents. The educational disparities were considerable 40 years ago, but have become markedly less over time. The analyses provide support for statistical discrimination theory, though agency theory cannot be totally excluded.

Suggested Citation

  • Grytten, Jostein & Skau, Irene & Sørensen, Rune, 2011. "Do expert patients get better treatment than others? Agency discrimination and statistical discrimination in obstetrics," Journal of Health Economics, Elsevier, vol. 30(1), pages 163-180, January.
  • Handle: RePEc:eee:jhecon:v:30:y:2011:i:1:p:163-180

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    References listed on IDEAS

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    9. Lin, Herng-Ching & Xirasagar, Sudha & Kao, Senyeong, 2004. "Association of hospital ownership with patient transfers to outpatient care under a prospective payment system in Taiwan," Health Policy, Elsevier, vol. 69(1), pages 11-19, July.
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    Cited by:

    1. Fiva, Jon H. & Hægeland, Torbjørn & Rønning, Marte & Syse, Astri, 2014. "Access to treatment and educational inequalities in cancer survival," Journal of Health Economics, Elsevier, vol. 36(C), pages 98-111.
    2. Erin M. Johnson & M. Marit Rehavi, 2016. "Physicians Treating Physicians: Information and Incentives in Childbirth," American Economic Journal: Economic Policy, American Economic Association, vol. 8(1), pages 115-141, February.
    3. repec:eee:hepoli:v:121:y:2017:i:9:p:986-993 is not listed on IDEAS
    4. Jakobsson, Niklas & Kotsadam, Andreas & Syse, Astri & Øien, Henning, 2016. "Gender bias in public long-term care? A survey experiment among care managers," Journal of Economic Behavior & Organization, Elsevier, vol. 131(PB), pages 126-138.


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