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The Effect of Physician Fees and Density Differences on Regional Variation in Hospital Treatments

Author

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  • Rudy Douven

    (CPB Netherlands Bureau for Economic Policy Analysis)

  • Remco Mocking
  • Ilaria Mosca

Abstract

We use a panel data set of about 1.7 million hospital records in 4,000 Dutch zip code regions for the years 2006-2009. We estimate the effect of physician fees and physician density on regional variation in hospital care for nine different treatments. We use a panel data set of about 1.7 million hospital records in 4,000 Dutch zip code regions for the years 2006-2009. We estimate the effect of physician fees and physician density on regional variation in hospital care for nine different treatments. Our results show that a 1 percent increase in the total number of physicians, if these extra physicians are all paid according to an output-based reimbursement scheme, would increase the number of treatments on average by 0.40 percent. For salaried physicians we find a significantly lower average effect of 0.15 percent. We find no or weak effects for hip fractures, which is included in the analysis as a control treatment. Our data allows us to deal with reverse causality, excess demand, border crossing, and availability effects. Our findings lend support to the existence of supplier induced demand for the majority of the analyzed treatments.

Suggested Citation

  • Rudy Douven & Remco Mocking & Ilaria Mosca, 2012. "The Effect of Physician Fees and Density Differences on Regional Variation in Hospital Treatments," CPB Discussion Paper 208, CPB Netherlands Bureau for Economic Policy Analysis.
    • Handle: RePEc:cpb:discus:208
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    1. Heijink, Richard & Mosca, Ilaria & Westert, Gert, 2013. "Effects of regulated competition on key outcomes of care: Cataract surgeries in the Netherlands," Health Policy, Elsevier, vol. 113(1), pages 142-150.
    2. Jos Blank & Evelien Eggink, 2014. "The impact of policy on hospital productivity: a time series analysis of Dutch hospitals," Health Care Management Science, Springer, vol. 17(2), pages 139-149, June.
    3. Rudy Douven & Minke Remmerswaal & Ilaria Mosca, 2014. "Unintended effects of reimbursement schedules in mental health care," CPB Discussion Paper 292, CPB Netherlands Bureau for Economic Policy Analysis.
    4. Rudy Douven & Minke Remmerswaal & Ilaria Mosca, 2014. "Unintended effects of reimbursement schedules in mental health care," CPB Discussion Paper 292.rdf, CPB Netherlands Bureau for Economic Policy Analysis.
    5. Oliver Fritz & Peter Mayerhofer & Reinhard Haller & Gerhard Streicher & Florian Bachner & Herwig Ostermann, 2013. "Die regionalwirtschaftlichen Effekte der österreichischen Krankenanstalten," WIFO Studies, WIFO, number 46672, February.
    6. Jante Parlevliet & Thomas Kooiman, 2015. "Wealth formation of Dutch households: a policy assessment," DNB Occasional Studies 1301, Netherlands Central Bank, Research Department.

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