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Physician's production of primary care in Ontario, Canada

Author

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  • Sisira Sarma

    (Department of Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, University of Western Ontario, London, Ont., Canada)

  • Rose Anne Devlin

    (Department of Economics, University of Ottawa, Ottawa, Ont., Canada)

  • William Hogg

    (Department of Family Medicine, University of Ottawa, Ottawa, Ont., Canada)

Abstract

This paper examines the factors affecting the number of patient visits per week reported by family physicians in Ontario. The way that a physician is paid is potentially endogenous to the number of patients seen per week, thus an instrumental variable method of estimation is employed to account for the endogeneity bias. Once account is taken of the endogeneity of remuneration as well as relevant physician and practice characteristics, the estimated elasticity of output with respect to hours worked is 0.74; 0.68 in group practices and 0.82 in solo practices. Physicians paid on a non-fee-for-service (NFFS) conduct 15-31% fewer patient visits per week in comparison to those paid under an FFS scheme. Certain patient populations in practices affect patient visits in important ways, as do a number of physician and practice characteristics. Copyright © 2009 John Wiley & Sons, Ltd.

Suggested Citation

  • Sisira Sarma & Rose Anne Devlin & William Hogg, 2010. "Physician's production of primary care in Ontario, Canada," Health Economics, John Wiley & Sons, Ltd., vol. 19(1), pages 14-30.
  • Handle: RePEc:wly:hlthec:v:19:y:2010:i:1:p:14-30
    DOI: 10.1002/hec.1447
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    File URL: http://hdl.handle.net/10.1002/hec.1447
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    References listed on IDEAS

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    Cited by:

    1. Lukas Kwietniewski & Mareike Heimeshoff & Jonas Schreyögg, 2017. "Estimation of a physician practice cost function," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 18(4), pages 481-494, May.
    2. Rudoler, David & Laporte, Audrey & Barnsley, Janet & Glazier, Richard H. & Deber, Raisa B., 2015. "Paying for primary care: A cross-sectional analysis of cost and morbidity distributions across primary care payment models in Ontario Canada," Social Science & Medicine, Elsevier, vol. 124(C), pages 18-28.
    3. Sarma, Sisira & Devlin, Rose Anne & Belhadji, Bachir & Thind, Amardeep, 2010. "Does the way physicians are paid influence the way they practice? The case of Canadian family physicians' work activity," Health Policy, Elsevier, vol. 98(2-3), pages 203-217, December.
    4. David Gray & William Hogg & Michael E. Green & Yan Zhang, 2015. "Did Family Physicians Who Opted into a New Payment Model Receive an Offer They Should Not Refuse? Experimental Evidence from Ontario," Canadian Public Policy, University of Toronto Press, vol. 41(2), pages 151-165, June.
    5. Sibley, Lyn M. & Glazier, Richard H., 2012. "Evaluation of the equity of age–sex adjusted primary care capitation payments in Ontario, Canada," Health Policy, Elsevier, vol. 104(2), pages 186-192.
    6. Timothy Gunning & Robin Sickles, 2013. "Competition and market power in physician private practices," Empirical Economics, Springer, vol. 44(2), pages 1005-1029, April.
    7. Sarma, Sisira & Thind, Amardeep & Chu, Man-Kee, 2011. "Do new cohorts of family physicians work less compared to their older predecessors? The evidence from Canada," Social Science & Medicine, Elsevier, vol. 72(12), pages 2049-2058, June.
    8. repec:eee:jhecon:v:55:y:2017:i:c:p:76-94 is not listed on IDEAS
    9. Galina Besstremyannaya, 2015. "Heterogeneous effect of residency matching and prospective payment on labor returns and hospital scale economies," Discussion Papers 15-001, Stanford Institute for Economic Policy Research.
    10. David Rudoler & Raisa Deber & Janet Barnsley & Richard H. Glazier & Adrian Rohit Dass & Audrey Laporte, 2015. "Paying for Primary Care: The Factors Associated with Physician Self‐selection into Payment Models," Health Economics, John Wiley & Sons, Ltd., vol. 24(9), pages 1229-1242, September.
    11. Olga Milliken & Rose Anne Devlin & Vicky Barham & William Hogg & Simone Dahrouge & Grant Russell, 2008. "Comparative Efficiency Assessment of Primary Care Models Using Data Envelopment Analysis," Working Papers 0802E, University of Ottawa, Department of Economics.
    12. Kim Olsen & Dorte Gyrd-Hansen & Torben Sørensen & Troels Kristensen & Peter Vedsted & Andrew Street, 2013. "Organisational determinants of production and efficiency in general practice: a population-based study," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 14(2), pages 267-276, April.

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