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Patient switching in general practice

  • Iversen, Tor
  • Lurås, Hilde

Patients switching physicians involves costs to the patients because of less continuity of care. From a theoretical model we derive that inferior physician quality as perceived by patients, implies patient shortage for the physician and more patients switching physicians. By means of a unique panel data set covering the entire population of Norwegian general practitioners (GPs) and estimation methods that adjust for potential endogeneities, we find that the occurrence of patient shortage increases the proportion of patients switching physicians by 50%. A competing hypothesis that GPs with a shortage of patients experience less switching because of superior access is rejected by data. To assist patients in making informed decisions, we suggest that the number of switches a physician experiences should be made public.

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Article provided by Elsevier in its journal Journal of Health Economics.

Volume (Year): 30 (2011)
Issue (Month): 5 ()
Pages: 894-903

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Handle: RePEc:eee:jhecon:v:30:y:2011:i:5:p:894-903
Contact details of provider: Web page: http://www.elsevier.com/locate/inca/505560

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  1. Sitzia, John & Wood, Neil, 1997. "Patient satisfaction: A review of issues and concepts," Social Science & Medicine, Elsevier, vol. 45(12), pages 1829-1843, December.
  2. 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.
  3. Hausman, Jerry A & Taylor, William E, 1981. "Panel Data and Unobservable Individual Effects," Econometrica, Econometric Society, vol. 49(6), pages 1377-98, November.
  4. 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.
  5. Kalda, R. & Polluste, K. & Lember, M., 2003. "Patient satisfaction with care is associated with personal choice of physician," Health Policy, Elsevier, vol. 64(1), pages 55-62, April.
  6. Wolinsky, Fredric D. & Steiber, Steven R., 1982. "Salient issues in choosing a new doctor," Social Science & Medicine, Elsevier, vol. 16(7), pages 759-767, January.
  7. Hugh Gravelle & Giuliano Masiero, . "Quality incentives in a regulated market with imperfect information and switching costs: capitation in general practice," Discussion Papers 00/18, Department of Economics, University of York.
  8. 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.
  9. Klemperer, Paul, 1995. "Competition When Consumers Have Switching Costs: An Overview with Applications to Industrial Organization, Macroeconomics, and International Trade," Review of Economic Studies, Wiley Blackwell, vol. 62(4), pages 515-39, October.
  10. Grytten, Jostein & Sørensen, Rune, 2008. "Busy physicians," Journal of Health Economics, Elsevier, vol. 27(2), pages 510-518, March.
  11. Iversen, Tor, 2009. "A study of income-motivated behavior among general practitioners in the Norwegian list patient system," HERO On line Working Paper Series 2005:8, Oslo University, Health Economics Research Programme.
  12. Grytten, Jostein & Sørensen, Rune J., 2009. "Patient choice and access to primary physician services in Norway," Health Economics, Policy and Law, Cambridge University Press, vol. 4(01), pages 11-27, January.
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