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Market Conditions and General Practitioners' Referrals

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  • Tor Iversen

    () (Institute of Health Management and Health Economics, University of Oslo)

  • Ching-to Albert Ma

    () (Department of Economics, Boston University)

Abstract

We study how market conditions in?uence referrals of patients by general practitioners (GPs). We set up a model of GP referral for the Norwegian health care system, where a GP receives capitation payment based on the number of patients in his practice, as well as fee-for-service reimbursements. A GP may accept new patients or close the practice to new patients. We model GPs as partially altruistic, and compete for patients. We show that a GP operating in a more competitive market refers more. To retain patients in his practice, a GP satis?es patients' requests for referrals. Furthermore, a GP who faces patient shortage will refer more often than a GP who has enough patients. More referrals may add to pro?ts from future treatments. Using data of radiology referrals by GPs in Norway, we test and confirm our theory.

Suggested Citation

  • Tor Iversen & Ching-to Albert Ma, "undated". "Market Conditions and General Practitioners' Referrals," Boston University - Department of Economics - Working Papers Series wp2009-009, Boston University - Department of Economics.
  • Handle: RePEc:bos:wpaper:wp2009-009
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    Cited by:

    1. Schaumans, Catherine, 2015. "Prescribing behavior of General Practitioners: Competition matters," Health Policy, Elsevier, vol. 119(4), pages 456-463.
    2. Brekke, Kurt R. & Holmås, Tor Helge & Monstad, Karin & Straume, Odd Rune, 2017. "Competition and physician behaviour: Does the competitive environment the propensity to issue sickness certificates?," Discussion Paper Series in Economics 3/2017, Norwegian School of Economics, Department of Economics.
    3. Tor Iversen & Anastasia Mokienko, 2016. "Supplementing gatekeeping with a revenue scheme for secondary care providers," International Journal of Health Economics and Management, Springer, vol. 16(3), pages 247-267, September.
    4. Dietrichson, Jens & Ellegård, Lina Maria & Kjellsson, Gustav, 2016. "Effects of Increased Competition on Quality of Primary Care in Sweden," Working Papers 2016:36, Lund University, Department of Economics.
    5. 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.
    6. Godager, Geir & Iversen, Tor & Ma, Ching-to Albert, 2015. "Competition, gatekeeping, and health care access," Journal of Health Economics, Elsevier, vol. 39(C), pages 159-170.
    7. Siciliani, Luigi & Chalkley, Martin & Gravelle, Hugh, 2017. "Policies towards hospital and GP competition in five European countries," Health Policy, Elsevier, vol. 121(2), pages 103-110.
    8. Brosig-Koch, Jeannette & Hehenkamp, Burkhard & Kokot, Johanna, 2016. "The effects of competition on medical service provision," Annual Conference 2016 (Augsburg): Demographic Change 145589, Verein für Socialpolitik / German Economic Association.
    9. Tor Iversen & Hilde Lurås, 2012. "Capitation and Incentives in Primary Care," Chapters,in: The Elgar Companion to Health Economics, Second Edition, chapter 26 Edward Elgar Publishing.
    10. Brekke, Kurt R. & Straume, Odd Rune, 2017. "Competition policy for health care provision in Norway," Health Policy, Elsevier, vol. 121(2), pages 134-140.
    11. Markussen, Simen & Røed, Knut, 2017. "The market for paid sick leave," Journal of Health Economics, Elsevier, vol. 55(C), pages 244-261.
    12. Drabik, Dusan & de Gorter, Harry & Timilsina, Govinda R., 2016. "Producing biodiesel from soybeans in Zambia: An economic analysis," Food Policy, Elsevier, vol. 59(C), pages 103-109.
    13. Kurt R. Brekke & Tor Helge Holmäs & Karin Monstad & Odd Rune Straume, 2017. "Competition and physician behaviour: Does the competitive environment affect the propensity to issue sickness certificates?," NIPE Working Papers 05/2017, NIPE - Universidade do Minho.

    More about this item

    JEL classification:

    • C23 - Mathematical and Quantitative Methods - - Single Equation Models; Single Variables - - - Models with Panel Data; Spatio-temporal Models
    • H42 - Public Economics - - Publicly Provided Goods - - - Publicly Provided Private Goods
    • I11 - Health, Education, and Welfare - - Health - - - Analysis of Health Care Markets
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health

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