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Patient switching in general practice

Author

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  • Iversen, Tor
  • Lurås, Hilde

Abstract

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.

Suggested Citation

  • Iversen, Tor & Lurås, Hilde, 2011. "Patient switching in general practice," Journal of Health Economics, Elsevier, vol. 30(5), pages 894-903.
  • Handle: RePEc:eee:jhecon:v:30:y:2011:i:5:p:894-903 DOI: 10.1016/j.jhealeco.2011.07.008
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    References listed on IDEAS

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    1. 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.
    2. 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.
    3. 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.
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    6. Grytten, Jostein & Sørensen, Rune, 2008. "Busy physicians," Journal of Health Economics, Elsevier, vol. 27(2), pages 510-518, March.
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    8. 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.
    9. Cameron,A. Colin & Trivedi,Pravin K., 2008. "Microeconometrics," Cambridge Books, Cambridge University Press, number 9787111235767, March.
    10. Gravelle, Hugh & Masiero, Giuliano, 2000. "Quality incentives in a regulated market with imperfect information and switching costs: capitation in general practice," Journal of Health Economics, Elsevier, vol. 19(6), pages 1067-1088, November.
    11. 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.
    12. Sitzia, John & Wood, Neil, 1997. "Patient satisfaction: A review of issues and concepts," Social Science & Medicine, Elsevier, vol. 45(12), pages 1829-1843, December.
    13. 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.
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    Cited by:

    1. repec:eee:jhecon:v:55:y:2017:i:c:p:244-261 is not listed on IDEAS
    2. 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.
    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, Department of Economics, University of Bristol, UK.
    4. Godager, Geir & Iversen, Tor & Ma, Ching-to Albert, 2015. "Competition, gatekeeping, and health care access," Journal of Health Economics, Elsevier, vol. 39(C), pages 159-170.
    5. 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.
    6. Tor Iversen & Anastasia Mokienko, 2016. "Supplementing gatekeeping with a revenue scheme for secondary care providers," International Journal of Health Economics and Management, Springer, vol. 16(3), pages 247-267, September.
    7. Markussen, Simen & Røed, Knut, 2017. "The market for paid sick leave," Journal of Health Economics, Elsevier, vol. 55(C), pages 244-261.
    8. 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.

    More about this item

    Keywords

    Switching; Revealed preferences; Capitation; General practice; Patient shortage;

    JEL classification:

    • H42 - Public Economics - - Publicly Provided Goods - - - Publicly Provided Private Goods
    • I11 - Health, Education, and Welfare - - Health - - - Analysis of Health Care Markets
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health

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