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Competition, prices, and quality in the market for physician consultations

Author

Listed:
  • Hugh Gravelle

    (Centre for Health Economics, University of York, UK)

  • Anthony Scott

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

  • Peter Sivey

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

  • Jongsay Yong

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

Abstract

Prices for consultations with General Practitioners (GPs) in Australia are unregulated, and patients pay the difference between the price set by the GP and a fixed reimbursement from the national taxfunded Medicare insurance scheme. We construct a Vickrey-Salop model of GP price and quality competition and test its predictions using a dataset with individual GP-level data on prices, the proportion of patients who are charged no out-of-pocket fee, average consultation length, and characteristics of the GPs, their practices and their local areas. We measure the competition to which the GP is exposed by the distance to other GPs and allow for the endogeneity of GP location decisions with measures of area characteristics and area fixed-effects. Within areas, GPs with more distant competitors charge higher prices and a smaller proportion of their patients make no out-ofpocket payment. GPs with more distant competitors also have shorter consultations, though the effect is small and statistically insignificant.

Suggested Citation

  • Hugh Gravelle & Anthony Scott & Peter Sivey & Jongsay Yong, 2013. "Competition, prices, and quality in the market for physician consultations," Working Papers 089cherp, Centre for Health Economics, University of York.
    • Handle: RePEc:chy:respap:89cherp
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    References listed on IDEAS

    as
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    Citations

    Blog mentions

    As found by EconAcademics.org, the blog aggregator for Economics research:
    1. #HEJC papers for August 2013
      by academichealtheconomists in The Academic Health Economists' Blog on 2013-08-01 04:00:48

    Citations

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

    1. Gravelle, H & Liu, D & Propper, C & Santos, R, 2018. "Spatial competition and quality: evidence from the English family doctor market," Working Papers 60680, Imperial College, London, Imperial College Business School.
    2. 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.
    3. repec:tpr:amjhec:v:4:y:2018:i:2:p:226-261 is not listed on IDEAS
    4. 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.
    5. Bisceglia, Michele & Cellini, Roberto & Grilli, Luca, 2017. "Regional regulators in healthcare service under quality competition: A game theoretical model," MPRA Paper 80507, University Library of Munich, Germany.
    6. repec:eee:regeco:v:64:y:2017:i:c:p:117-136 is not listed on IDEAS
    7. 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.
    8. Benjamin Montmartin & Mathieu Escot, 2017. "Local Competition and Physicians’ Pricing Decisions: New Evidence from France," GREDEG Working Papers 2017-31, Groupe de REcherche en Droit, Economie, Gestion (GREDEG CNRS), University of Nice Sophia Antipolis.
    9. repec:eee:socmed:v:214:y:2018:i:c:p:197-205 is not listed on IDEAS
    10. Dietrichson, Jens & Ellegård, Lina Maria & Kjellsson, Gustav, 2016. "Patient Choice, Entry, and the Quality of Primary Care: Evidence from Swedish Reforms," Working Papers 2016:36, Lund University, Department of Economics, revised 27 Jun 2018.
    11. Dieter Pennerstorfer, 2014. "Price and Quality Competition in Spatial Markets. The Case of Camping Sites," WIFO Working Papers 466, WIFO.
    12. Anthony Scott & Peter Sivey, 2017. "Motivation and Competition in Health Care," Melbourne Institute Working Paper Series wp2017n05, Melbourne Institute of Applied Economic and Social Research, The University of Melbourne.
    13. Abe Dunn & Adam Hale Shapiro, 2018. "Physician Competition and the Provision of Care: Evidence from Heart Attacks," American Journal of Health Economics, MIT Press, vol. 4(2), pages 226-261, Spring.
    14. Choné, P. & Coudin, É. & Pla, A., 2014. "Are physician fees responsive to competition?," Health, Econometrics and Data Group (HEDG) Working Papers 14/20, HEDG, c/o Department of Economics, University of York.

    More about this item

    Keywords

    Competition; Prices; Quality of care; Primary care; Doctors;

    JEL classification:

    • I11 - Health, Education, and Welfare - - Health - - - Analysis of Health Care Markets
    • I13 - Health, Education, and Welfare - - Health - - - Health Insurance, Public and Private
    • L1 - Industrial Organization - - Market Structure, Firm Strategy, and Market Performance

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