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Socio‐economic status and physicians' treatment decisions

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  • Kurt R. Brekke
  • Tor Helge Holmås
  • Karin Monstad
  • Odd Rune Straume

Abstract

This paper studies the relationship between patients' socio‐economic status and general practitioners' (GPs') service provision by exploiting administrative patient‐level data with information on consultation length, medical tests, and fee payments for each visit in Norway over a 5‐year period (2008–2012). To reduce patient heterogeneity, we limit the sample to a given condition, diabetes type II, that is treated almost exclusively in primary care. We estimate GP fixed‐effect models and control for a wide set of patient characteristics. Our results show that, for each visit, patients with low education get shorter consultations but more medical tests, patients with low income get less of both, and patients with low education/income get less services in monetary terms. We also find that, during a year, patients with low education/income visit the GP more often and receive more services in monetary terms. Thus, GPs treat patients differently according to their socio‐economic status, but we find no support for a social gradient.

Suggested Citation

  • Kurt R. Brekke & Tor Helge Holmås & Karin Monstad & Odd Rune Straume, 2018. "Socio‐economic status and physicians' treatment decisions," Health Economics, John Wiley & Sons, Ltd., vol. 27(3), pages 77-89, March.
  • Handle: RePEc:wly:hlthec:v:27:y:2018:i:3:p:e77-e89
    DOI: 10.1002/hec.3621
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    1. Sveréus, Sofia & Kjellsson, Gustav & Rehnberg, Clas, 2018. "Socioeconomic distribution of GP visits following patient choice reform and differences in reimbursement models: Evidence from Sweden," Health Policy, Elsevier, vol. 122(9), pages 949-956.
    2. Moscelli, Giuseppe & Gravelle, Hugh & Siciliani, Luigi, 2023. "The effect of hospital choice and competition on inequalities in waiting times," Journal of Economic Behavior & Organization, Elsevier, vol. 205(C), pages 169-201.
    3. Turner, Alex J & Francetic, Igor & Watkinson, Ruth & Gillibrand, Stephanie & Sutton, Matt, 2022. "Socioeconomic inequality in access to timely and appropriate care in emergency departments," Journal of Health Economics, Elsevier, vol. 85(C).
    4. Rydland, Håvard T., 2020. "Monitoring the social gradient: Inequalities in use of blood pressure monitors in the HUNT study," Technology in Society, Elsevier, vol. 63(C).
    5. Clémence Bussière & Nicolas Sirven & Thomas Rapp & Christine Sevilla‐Dedieu, 2020. "Adherence to medical follow‐up recommendations reduces hospital admissions: Evidence from diabetic patients in France," Health Economics, John Wiley & Sons, Ltd., vol. 29(4), pages 508-522, April.
    6. Kaarboe, Oddvar & Siciliani, Luigi, 2023. "Contracts for primary and secondary care physicians and equity-efficiency trade-offs," Journal of Health Economics, Elsevier, vol. 87(C).

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    More about this item

    JEL classification:

    • I11 - Health, Education, and Welfare - - Health - - - Analysis of Health Care Markets
    • I14 - Health, Education, and Welfare - - Health - - - Health and Inequality
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health

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