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Does prescribing appropriateness reduce health expenditures? Main effects and unintended outcomes

Author

Listed:
  • Claudio Lucifora

    (Università Cattolica del Sacro Cuore
    Dipartimento di Economia e Finanza, Università Cattolica del Sacro Cuore)

  • Antonio Russo
  • Daria Vigani

    (Università Cattolica del Sacro Cuore
    Dipartimento di Economia e Finanza, Università Cattolica del Sacro Cuore)

Abstract

We evaluate the effectiveness of a reform to contain health-care costs by restraining general practitioners' (GP) ability to prescribe outpatient treatments, on the basis of strict appropriateness criteria. Using register data for a large Metropolitan area in Italy, we find a significant contraction in both outpatient expenditures (-24%) and volumes (-12%) after the reform. The effects on expenditures are found to be heterogeneous across GPs' characteristics, pointing out the mediating role of GPs' prescribing behavior. The reform also affected the composition of outpatient spending and produced unintended consequences on the demand for medical services of vulnerable groups, who were originally excluded from its application, as well as on access to emergency care.

Suggested Citation

  • Claudio Lucifora & Antonio Russo & Daria Vigani, 2021. "Does prescribing appropriateness reduce health expenditures? Main effects and unintended outcomes," DISCE - Working Papers del Dipartimento di Economia e Finanza def103, Università Cattolica del Sacro Cuore, Dipartimenti e Istituti di Scienze Economiche (DISCE).
    • Handle: RePEc:ctc:serie1:def103
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    References listed on IDEAS

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    Cited by:

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    4. Basiglio, Stefania & Foresta, Alessandra & Turati, Gilberto, 2024. "Impatience and crime. Evidence from the NLSY97," Journal of Economic Psychology, Elsevier, vol. 101(C).
    5. Daniele Checchi & Alessandra Fenizia & Claudio Lucifora, 2021. "PUBLIC SECTOR JOBS: Working in the public sector in Europe and the US," DISCE - Working Papers del Dipartimento di Economia e Finanza def107, Università Cattolica del Sacro Cuore, Dipartimenti e Istituti di Scienze Economiche (DISCE).
    6. Russell Davidson & Andrea Monticini, 2023. "Bootstrap Performance with Heteroskedasticity," DISCE - Working Papers del Dipartimento di Economia e Finanza def130, Università Cattolica del Sacro Cuore, Dipartimenti e Istituti di Scienze Economiche (DISCE).
    7. Luca Armanaschi & Elisabetta Barzan & Magda Cavallucci & Carlo Federici & Marco Sartirana & Florian Zerzer, 2022. "I dati amministrativi per la governance dei tempi di attesa delle prestazioni ambulatoriali: l?esperienza dell?Azienda Sanitaria dell?Alto Adige," MECOSAN, FrancoAngeli Editore, vol. 2022(123), pages 53-75.
    8. Irene Torrini & Claudio Lucifora & Antonio Russo, 2022. "The Long-Term Effects of Hospitalization on Health Care Expenditures: An Empirical Analysis for the Young-Old Population," DISCE - Working Papers del Dipartimento di Economia e Finanza def117, Università Cattolica del Sacro Cuore, Dipartimenti e Istituti di Scienze Economiche (DISCE).

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    More about this item

    Keywords

    Prescribing appropriateness; Health-care expenditures; Primary care.;
    All these keywords.

    JEL classification:

    • H51 - Public Economics - - National Government Expenditures and Related Policies - - - Government Expenditures and Health
    • I38 - Health, Education, and Welfare - - Welfare, Well-Being, and Poverty - - - Government Programs; Provision and Effects of Welfare Programs
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health

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