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The effect of capitation on GPs' referral decisions

Author

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  • Tor Iversen

    (Center for Health Administration, University of Oslo, Norway)

  • Hilde Lurås

    (Center for Health Administration, University of Oslo, Norway)

Abstract

In the Norwegian capitation trial, the payment system for general practitioners (GPs) has been changed; a practice allowance component has been replaced by a capitation component and the fee-per-item component constitutes a smaller part of a GPs practice income than previously. From the theoretical modelling of GPs' referral decisions, we predict that the replacement of the practice allowance by a capitation component will increase the rate of referrals to specialists. This hypothesis is supported by an exploratory empirical study with data from a sample of GPs participating in the experiment. Copyright © 2000 John Wiley & Sons, Ltd.

Suggested Citation

  • Tor Iversen & Hilde Lurås, 2000. "The effect of capitation on GPs' referral decisions," Health Economics, John Wiley & Sons, Ltd., vol. 9(3), pages 199-210.
  • Handle: RePEc:wly:hlthec:v:9:y:2000:i:3:p:199-210
    DOI: 10.1002/(SICI)1099-1050(200004)9:3<199::AID-HEC514>3.0.CO;2-2
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    References listed on IDEAS

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    1. B Hutchison & S Birch & J Hurley & J Lomas & F Stratford-Devai, 1994. "Do Physician Payment Mechanisms Affect Hospital Utilization? A Study of Health Service Organizations in Ontario," Centre for Health Economics and Policy Analysis Working Paper Series 1994-02, Centre for Health Economics and Policy Analysis (CHEPA), McMaster University, Hamilton, Canada.
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    Cited by:

    1. Lurås, Hilde, 2009. "General Practice: Four Empirical Essays on GP Behaviour and Individuals’ Preferences for GPs," HERO On line Working Paper Series 2004:1, Oslo University, Health Economics Research Programme.
    2. Iversen, Tor & Lurås, Hilde, 2009. "The importance of micro-data for revaealing income motivated behaviour among GPs," HERO On line Working Paper Series 1999:3, Oslo University, Health Economics Research Programme.
    3. Lim, Jae-Young & Jo, Changik, 2009. "The Effect of Patient's Asymmetric Information Problem on Medical Care Utilization with Consideration of a Patient's Ex-ante Health Status," Hitotsubashi Journal of Economics, Hitotsubashi University, vol. 50(2), pages 37-58, December.
    4. Tor Iversen & Ching-to Ma, 2011. "Market conditions and general practitioners’ referrals," International Journal of Health Economics and Management, Springer, vol. 11(4), pages 245-265, December.
    5. Cox, James C. & Sadiraj, Vjollca & Schnier, Kurt E. & Sweeney, John F., 2016. "Incentivizing cost-effective reductions in hospital readmission rates," Journal of Economic Behavior & Organization, Elsevier, vol. 131(PB), pages 24-35.
    6. Hennig-Schmidt, Heike & Selten, Reinhard & Wiesen, Daniel, 2011. "How payment systems affect physicians' provision behaviour--An experimental investigation," Journal of Health Economics, Elsevier, vol. 30(4), pages 637-646, July.
    7. Marisol Rodríguez & Alexandrina Stoyanova, 2004. "The effect of private insurance access on the choice of GP|specialist and public|private provider in Spain," Health Economics, John Wiley & Sons, Ltd., vol. 13(7), pages 689-703.
    8. Marie Allard & Izabela Jelovac & Pierre-Thomas Léger, 2014. "Payment mechanism and GP self-selection: capitation versus fee for service," International Journal of Health Economics and Management, Springer, vol. 14(2), pages 143-160, June.
    9. Iversen, Tor & Kopperud, Gry Stine, 2009. "The impact of accessibility on the use of specialist health care in Norway," HERO On line Working Paper Series 2002:9, Oslo University, Health Economics Research Programme.
    10. Himmel, Konrad & Schneider, Udo, 2017. "Ambulatory care at the end of a billing period," hche Research Papers 2017/14, University of Hamburg, Hamburg Center for Health Economics (hche).
    11. Kjeld Møller Pedersen & Terkel Christiansen & Mickael Bech, 2005. "The Danish health care system: evolution - not revolution - in a decentralized system," Health Economics, John Wiley & Sons, Ltd., vol. 14(S1), pages 41-57.
    12. Li, JingJing & Godager, Geir & Wang, Jian, 2016. "Does physician gender influence the provision of medical care? An experimental study," HERO On line Working Paper Series 2016:6, Oslo University, Health Economics Research Programme.

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