Effect of regulated user fee on quality of healthcare for the poor and the non-poor
User fee for healthcare continues to be used in many countries despite the extensive documentation on the impoverishing effect on households. The literature has also analyzed the effect of user fee on the quality of care for both rich and poor. The purpose of this study is to find the factors affecting the physician’s behavior, under a user fee payment mechanism with an exemption program for the poor, when choosing treatment for poor and non-poor patients. The factors examined were treatment effort input, the fine, cost of investigation, costliness of government, severity of illness for the non-poor and for the poor, and the proportion of non-poor patients. The results showed that regulated user fee cannot be effectively implemented without government investigation or monitoring of the health provider’s treatment choice. The possibility of investigation provides incentive for the provider to choose the proper treatment quality when the poor are likely to be high risk than the non-poor. An important result is that regulated user fee can deteriorate the quality of care received by the rich, through excessive treatment, especially in developing economies where there is a small proportion of the rich. Improvement in innovative technologies that reduce the cost of investigation, government revenue collection, and treatment effort input is likely to improve the quality of care provided to patients regardless of income status. Copyright Springer-Verlag Berlin Heidelberg 2013
Volume (Year): 60 (2013)
Issue (Month): 4 (December)
|Contact details of provider:|| Web page: http://www.springer.com|
Web page: http://www.heirs.it/
|Order Information:||Web: http://www.springer.com/economics/policy/journal/12232/PS2|
Please report citation or reference errors to , or , if you are the registered author of the cited work, log in to your RePEc Author Service profile, click on "citations" and make appropriate adjustments.:
- Brekke, Kurt R. & Nuscheler, Robert & Straume, Odd Rune, 2007.
"Gatekeeping in health care,"
Journal of Health Economics,
Elsevier, vol. 26(1), pages 149-170, January.
- Brekke, Kurt R. & Nuscheler, Robert, 2003. "Gatekeeping in health care," Working Papers in Economics 10/03, University of Bergen, Department of Economics.
- Kurt R. Brekke & Robert Nuscheler & Odd Rune Straume, 2005. "Gatekeeping in Health Care," CESifo Working Paper Series 1552, CESifo Group Munich.
- Odd Rune Straume & Kurt Brekke & Robert Nuscheler, 2004. "Gatekeeping In Health Care," Royal Economic Society Annual Conference 2004 83, Royal Economic Society.
- Ettner, Susan L., 1996. "New evidence on the relationship between income and health," Journal of Health Economics, Elsevier, vol. 15(1), pages 67-85, February.
- Ridde, Valéry & Diarra, Aïssa & Moha, Mahaman, 2011. "User fees abolition policy in Niger: Comparing the under five years exemption implementation in two districts," Health Policy, Elsevier, vol. 99(3), pages 219-225, March.
- Pierre Thomas Léger, 2000. "Quality control mechanisms under capitation payment for medical services," Canadian Journal of Economics, Canadian Economics Association, vol. 33(2), pages 564-586, May.
- Hunt, Jennifer, 2010. "Bribery in health care in Uganda," Journal of Health Economics, Elsevier, vol. 29(5), pages 699-707, September. Full references (including those not matched with items on IDEAS)
When requesting a correction, please mention this item's handle: RePEc:spr:inrvec:v:60:y:2013:i:4:p:357-373. See general information about how to correct material in RePEc.
For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: (Sonal Shukla)or (Rebekah McClure)
If references are entirely missing, you can add them using this form.