Individuals' preferences for GPs Choice analysis from the establishment of a list patient system in Norway

The purpose of this paper is to gain more knowledge concerning individuals’ preferences for alternative GPs within a municipality. We have data on the population’s first, second and third choice of GPs. The data stem from the entry form the inhabitant filled in as a result of the implementation of a list patient system in general practice in Norway. To assess the potential demand for GPs3 or individuals’ request for a position on a certain GP’s list, we formulate and estimate a structural demand model based on probabilistic theories of individual choice behaviour. The model originates from the work of Luce (see for instance Luce, 1959 and Block and Marschak, 1960). Such models are successfully used to obtain knowledge of people’s preferences for different transportation vehicles. We raise the question of whether individuals’ choice of GPs is informed or purely random, as well as the question of whether observable demographic characteristics of a GP can tell us anything about the person who wants him or her as a personal physician. We find systematic dependencies between characteristics of an individual and characteristics of his or her choice of a GP. But we also find that the random part plays a major role in the choice process. In the last part of the paper we discuss policy implications of our findings. Central points are both how local health authorities can use the information on rankings to put together collegiums of GPs that serve the need – or the demand – of the inhabitants in the best way, and how a payment system for GPs should be designed if our results should be taken into account.