The "gatekeeping" role of general practitioners. Does patients' information matter ?
We deal with a principal-agent model in which the health authority acts as a principal for both a patient and a General Practitioner (GP). In this framework, we study the role of GPs as filters for secondary care, emphasizing the implications that patients' information may have for health authorities. We derive the GP's payment contract that induces him to perform diagnosis and follow its recommendation, as well as the level of copayments that provide patients with incentives to select the appropriate medical provider. We show that when patients can freely choose their provider, the quality of their information has contradictory effects. The higher this quality is, the lower the expected losses the patient bears. A higher quality, however, worsens the GP's agency problem, as GPs have more incentives to use patients' information as a substitute for their own diagnosis. We also analyze the role of patients' pressure for referral on the choice of the optimal system to access secondary care.
|Date of creation:||00 Dec 2003|
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"Gatekeeping in health care,"
Working Papers in Economics
10/03, University of Bergen, Department of Economics.
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- Croxson, B. & Propper, C. & Perkins, A., 2001. "Do doctors respond to financial incentives? UK family doctors and the GP fundholder scheme," Journal of Public Economics, Elsevier, vol. 79(2), pages 375-398, February.
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