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Do regional primary-care organisations influence primary-care performance? A dynamic panel estimation


  • Anthony Scott

    (Melbourne Institute of Applied Economic and Social Research, The University of Melbourne, Australia)

  • William Coote

    (Coote Practice Pty. Ltd, Canberra, Australia)


The role of regional primary-care organizations (PCOs) in health-care systems is not well understood. This is the first study to attempt to isolate the effect of regional PCOs on primary-care performance. We examine Divisions of General Practice in Australia, which were established in 1992. A unique Division-level panel data set is used to examine the effect of Divisions, and their activities, on various aspects of primary-care performance. Dynamic panel estimation is used to account for state dependence and the endogeneity of Divisions' activities. The results show that Divisions were more likely to have influenced general practice infrastructure than clinical performance in diabetes, asthma and cervical screening. The effect of specific Division activities, such as providing support for practice nurses and IT support, was not directly related to changes in the level of general practice performance. Specific support in the areas of diabetes and asthma was associated with general practice performance, but this was due to reverse causality and the effect of unobservable factors, rather than the direct effect of Divisions. Copyright © 2009 John Wiley & Sons, Ltd.

Suggested Citation

  • Anthony Scott & William Coote, 2010. "Do regional primary-care organisations influence primary-care performance? A dynamic panel estimation," Health Economics, John Wiley & Sons, Ltd., vol. 19(6), pages 716-729.
  • Handle: RePEc:wly:hlthec:v:19:y:2010:i:6:p:716-729
    DOI: 10.1002/hec.1509

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    References listed on IDEAS

    1. Scott, A & Schurer, S & Jensen, P H & Sivey, P, 2008. "The Effects of Financial Incentives on Quality of Care: The Case of Diabetes," Health, Econometrics and Data Group (HEDG) Working Papers 08/15, HEDG, c/o Department of Economics, University of York.
    2. Arellano, Manuel & Bover, Olympia, 1995. "Another look at the instrumental variable estimation of error-components models," Journal of Econometrics, Elsevier, vol. 68(1), pages 29-51, July.
    3. Blundell, Richard & Bond, Stephen, 1998. "Initial conditions and moment restrictions in dynamic panel data models," Journal of Econometrics, Elsevier, vol. 87(1), pages 115-143, August.
    4. Simoens, Steven & Scott, Anthony, 2005. "Voluntary or compulsory health care reform?: The case of primary care organisations in Scotland," Health Policy, Elsevier, vol. 72(3), pages 351-358, June.
    5. Mundlak, Yair, 1978. "On the Pooling of Time Series and Cross Section Data," Econometrica, Econometric Society, vol. 46(1), pages 69-85, January.
    6. Manuel Arellano & Stephen Bond, 1991. "Some Tests of Specification for Panel Data: Monte Carlo Evidence and an Application to Employment Equations," Review of Economic Studies, Oxford University Press, vol. 58(2), pages 277-297.
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    Cited by:

    1. Jesmin, Shammima & Thind, Amardeep & Sarma, Sisira, 2012. "Does team-based primary health care improve patients’ perception of outcomes? Evidence from the 2007–08 Canadian Survey of Experiences with Primary Health," Health Policy, Elsevier, vol. 105(1), pages 71-83.

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