IDEAS home Printed from https://ideas.repec.org/a/wly/hlthec/v23y2014i9p1115-1133.html
   My bibliography  Save this article

What Explains The Quality And Price Of Gp Services? An Investigation Using Linked Survey And Administrative Data

Author

Listed:
  • Meliyanni Johar
  • Glenn Jones
  • Elizabeth Savage

Abstract

We examine patient socioeconomic status, the strength of the patient–doctor relationship and local area competition as determinants of the quality and price of GP services. We exploit a large‐sample patient data set in Australia and its linkage to administrative databases. The sample contains over 260 000 patients and over 12 600 GPs, observed between 2005 and 2010. Controlling for GP fixed effects and patient health, we find no strong evidence that quality differs by patient age, gender, country of origin, health concession card status and income, but quality is increased by stronger patient–doctor relationship. Using a competition measure that is defined at the individual GP level and not restricted to a local market, we find that competition lowers quality. Price is increasing in patient income, whereas competition has a small impact on price. Copyright © 2014 John Wiley & Sons, Ltd.

Suggested Citation

  • Meliyanni Johar & Glenn Jones & Elizabeth Savage, 2014. "What Explains The Quality And Price Of Gp Services? An Investigation Using Linked Survey And Administrative Data," Health Economics, John Wiley & Sons, Ltd., vol. 23(9), pages 1115-1133, September.
  • Handle: RePEc:wly:hlthec:v:23:y:2014:i:9:p:1115-1133
    DOI: 10.1002/hec.3071
    as

    Download full text from publisher

    File URL: https://doi.org/10.1002/hec.3071
    Download Restriction: no

    File URL: https://libkey.io/10.1002/hec.3071?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    References listed on IDEAS

    as
    1. Hugh Gravelle & Anthony Scott & Peter Sivey & Jongsay Yong, 2016. "Competition, prices and quality in the market for physician consultations," Journal of Industrial Economics, Wiley Blackwell, vol. 64(1), pages 135-169, March.
    2. Edward C. Norton, 1992. "Incentive Regulation of Nursing Homes: Specification Tests of the Markov Model," NBER Chapters, in: Topics in the Economics of Aging, pages 275-304, National Bureau of Economic Research, Inc.
    3. Norton, Edward C., 1992. "Incentive regulation of nursing homes," Journal of Health Economics, Elsevier, vol. 11(2), pages 105-128, August.
    4. Joseph J. Doyle Jr., 2005. "Health Insurance, Treatment and Outcomes: Using Auto Accidents as Health Shocks," NBER Working Papers 11099, National Bureau of Economic Research, Inc.
    5. Elizabeth Savage & Glenn Jones, 2004. "An Analysis of the General Practice Access Scheme on GP Incomes, Bulk Billing and Consumer Copayments," Australian Economic Review, The University of Melbourne, Melbourne Institute of Applied Economic and Social Research, vol. 37(1), pages 31-40, March.
    6. Meliyanni Johar & Glenn Jones & Elizabeth Savage, 2012. "Healthcare Expenditure Profile of Older Australians: Evidence from Linked Survey and Health Administrative Data," Economic Papers, The Economic Society of Australia, vol. 31(4), pages 451-463, December.
    7. Hugh Gravelle & Matt Sutton & Ada Ma, 2010. "Doctor Behaviour under a Pay for Performance Contract: Treating, Cheating and Case Finding?," Economic Journal, Royal Economic Society, vol. 120(542), pages 129-156, February.
    8. Carol Propper & Simon Burgess & Denise Gossage, 2008. "Competition and Quality: Evidence from the NHS Internal Market 1991–9," Economic Journal, Royal Economic Society, vol. 118(525), pages 138-170, January.
    9. Johar, Meliyanni, 2012. "Do doctors charge high income patients more?," Economics Letters, Elsevier, vol. 117(3), pages 596-599.
    10. Joseph J. Doyle, 2005. "Health Insurance, Treatment and Outcomes: Using Auto Accidents as Health Shocks," The Review of Economics and Statistics, MIT Press, vol. 87(2), pages 256-270, May.
    11. Anthony Scott & Stefanie Schurer & Paul H. Jensen & Peter Sivey, 2009. "The effects of an incentive program on quality of care in diabetes management," Health Economics, John Wiley & Sons, Ltd., vol. 18(9), pages 1091-1108, September.
    12. Sophie Béjean & Christine Peyron & Renaud Urbinelli, 2007. "Variations in activity and practice patterns: a French study for GPs," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 8(3), pages 225-236, September.
    13. Eijkenaar, Frank & Emmert, Martin & Scheppach, Manfred & Schöffski, Oliver, 2013. "Effects of pay for performance in health care: A systematic review of systematic reviews," Health Policy, Elsevier, vol. 110(2), pages 115-130.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Craike, Melinda & Wiesner, Glen & Enticott, Joanne & Bennie, Jason A. & Biddle, Stuart J.H., 2018. "Equity of a government subsidised exercise referral scheme: A population study," Social Science & Medicine, Elsevier, vol. 216(C), pages 20-25.
    2. Jens Dietrichson & Lina Maria Ellegård & Gustav Kjellsson, 2020. "Patient choice, entry, and the quality of primary care: Evidence from Swedish reforms," Health Economics, John Wiley & Sons, Ltd., vol. 29(6), pages 716-730, June.
    3. Meliyanni Johar, 2017. "The Evolution of Out-of-Hospital Medical Costs to and through Retirement," Economic Papers, The Economic Society of Australia, vol. 36(1), pages 17-31, March.

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Hugh Gravelle & Anthony Scott & Peter Sivey & Jongsay Yong, 2016. "Competition, prices and quality in the market for physician consultations," Journal of Industrial Economics, Wiley Blackwell, vol. 64(1), pages 135-169, March.
    2. Domenico Lisi & Luigi Siciliani & Odd Rune Straume, 2020. "Hospital competition under pay‐for‐performance: Quality, mortality, and readmissions," Journal of Economics & Management Strategy, Wiley Blackwell, vol. 29(2), pages 289-314, April.
    3. Amanda Cook, 2020. "Do the uninsured demand less care? Evidence from Maryland’s hospitals," International Journal of Health Economics and Management, Springer, vol. 20(3), pages 251-276, September.
    4. Mindy Marks & Moonkyung Kate Choi, 2019. "Baby Boomlets and Baby Health: Hospital Crowdedness, Hospital Spending, and Infant Health," American Journal of Health Economics, MIT Press, vol. 5(3), pages 376-406, Summer.
    5. Ammi, Mehdi & Fortier, Grant, 2017. "The influence of welfare systems on pay-for-performance programs for general practitioners: A critical review," Social Science & Medicine, Elsevier, vol. 178(C), pages 157-166.
    6. Hinterhuber, Andreas, 2017. "Value quantification capabilities in industrial markets," Journal of Business Research, Elsevier, vol. 76(C), pages 163-178.
    7. Johar, Meliyanni & Jones, Glenn & Keane, Micheal P. & Savage, Elizabeth & Stavrunova, Olena, 2013. "Discrimination in a universal health system: Explaining socioeconomic waiting time gaps," Journal of Health Economics, Elsevier, vol. 32(1), pages 181-194.
    8. F. P. Vlaanderen & M. A. Tanke & B. R. Bloem & M. J. Faber & F. Eijkenaar & F. T. Schut & P. P. T. Jeurissen, 2019. "Design and effects of outcome-based payment models in healthcare: a systematic review," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 20(2), pages 217-232, March.
    9. John Karl Scholz & Ananth Seshadri, 2016. "The Interaction between Consumption and Health in Retirement," Working Papers wp344, University of Michigan, Michigan Retirement Research Center.
    10. Akosa Antwi, Yaa & Moriya, Asako S. & Simon, Kosali I., 2015. "Access to health insurance and the use of inpatient medical care: Evidence from the Affordable Care Act young adult mandate," Journal of Health Economics, Elsevier, vol. 39(C), pages 171-187.
    11. Wagstaff, Adam & Lindelow, Magnus, 2008. "Can insurance increase financial risk?: The curious case of health insurance in China," Journal of Health Economics, Elsevier, vol. 27(4), pages 990-1005, July.
    12. Bernard Black & José-Antonio Espín-Sánchez & Eric French & Kate Litvak, 2017. "The Long-Term Effect of Health Insurance on Near-Elderly Health and Mortality," American Journal of Health Economics, University of Chicago Press, vol. 3(3), pages 281-311, Summer.
    13. Michael Anderson & Carlos Dobkin & Tal Gross, 2012. "The Effect of Health Insurance Coverage on the Use of Medical Services," American Economic Journal: Economic Policy, American Economic Association, vol. 4(1), pages 1-27, February.
    14. Benedic N. Ippolito, 2016. "Financial incentives, hospital care, and health outcomes: Evidence from fair pricing laws," AEI Economics Working Papers 863745, American Enterprise Institute.
    15. Mark Stabile & Sarah Thomson, 2014. "The Changing Role of Government in Financing Health Care: An International Perspective," Journal of Economic Literature, American Economic Association, vol. 52(2), pages 480-518, June.
    16. Gravelle, Hugh & Liu, Dan & Propper, Carol & Santos, Rita, 2019. "Spatial competition and quality: Evidence from the English family doctor market," Journal of Health Economics, Elsevier, vol. 68(C).
    17. Bünnings, Christian & Hafner, Lucas & Reif, Simon & Tauchmann, Harald, 2019. "In sickness and in health? Health shocks and relationship breakdown: Empirical evidence from Germany," FAU Discussion Papers in Economics 03/2019, Friedrich-Alexander University Erlangen-Nuremberg, Institute for Economics.
    18. Lamantia, Fabio & Pezzino, Mario, 2016. "Evolutionary efficacy of a Pay for Performance scheme with motivated agents," Journal of Economic Behavior & Organization, Elsevier, vol. 125(C), pages 107-119.
    19. Alexander, Diane & Currie, Janet & Schnell, Molly, 2019. "Check up before you check out: Retail clinics and emergency room use," Journal of Public Economics, Elsevier, vol. 178(C).
    20. Dionne, Georges & Michaud, Pierre-Carl & Pinquet, Jean, 2013. "A review of recent theoretical and empirical analyses of asymmetric information in road safety and automobile insurance," Research in Transportation Economics, Elsevier, vol. 43(1), pages 85-97.

    More about this item

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:wly:hlthec:v:23:y:2014:i:9:p:1115-1133. 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: . General contact details of provider: http://www3.interscience.wiley.com/cgi-bin/jhome/5749 .

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Wiley Content Delivery (email available below). General contact details of provider: http://www3.interscience.wiley.com/cgi-bin/jhome/5749 .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service hosted by the Research Division of the Federal Reserve Bank of St. Louis . RePEc uses bibliographic data supplied by the respective publishers.