IDEAS home Printed from
   My bibliography  Save this paper

Decision-making in general practice - the effect of financial incentives on the use of laboratory analyses


  • Fauli Munkerud, Siri

    () (Norwegian Quality Improvement of Laboratory Services in Primary Care (NOKLUS))


This paper examines the reaction of general practitioners (GPs) to a reform in 2004 in the remuneration system for using laboratory services in general practice. Data from Norway make it possible to distinguish between income motivation and service motivation. The purpose of this paper is to study whether income motivation exists, and if so, the degree of income motivation among general practitioners (GPs) in Norway regarding the use of laboratory services in general practices. We argue that the degree of income motivation among GPs is stronger when the physicians are uncertain about the utility of the laboratory service in question. We have panel data from actual physician-patient encounters in general practices in the years 2001-2004, and use discrete choice analysis and random effects models. Our results indicate that there may be an income motivation among GPs regarding using laboratory services as, after the reform, the GPs chose to use laboratory services less frequently where the fees had been most reduced. In addition, estimation results show that an increase in the fees will lead to a small but significant increase in use. The reform led to minor changes in the use of laboratory analyses in GPs’ offices, and we argue that financial incentives were diluted because they were in conflict with medical recommendations and existing medical practice. The patient’s age has the most influence on GPs’ choice regarding use of laboratory services. The results support the hypothesis that the impact of income increases with increasing uncertainty about diagnosis and treatment. The policy implication of our results is that financial incentives alone are not an effective tool for influencing the use of laboratory services in GPs’ offices.

Suggested Citation

  • Fauli Munkerud, Siri, 2009. "Decision-making in general practice - the effect of financial incentives on the use of laboratory analyses," HERO Online Working Paper Series 2008:13, University of Oslo, Health Economics Research Programme.
  • Handle: RePEc:hhs:oslohe:2008_013

    Download full text from publisher

    File URL:
    Download Restriction: no

    More about this item


    Financial incentives; laboratory analyses; diagnostic uncertainty; medical practice.;

    JEL classification:

    • I10 - Health, Education, and Welfare - - Health - - - General

    NEP fields

    This paper has been announced in the following NEP Reports:


    Access and download statistics


    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:hhs:oslohe:2008_013. See general information about how to correct material in RePEc.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: (Kristi Brinkmann Lenander). General contact details of provider: .

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    We have no references for this item. You can help adding them by using this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service hosted by the Research Division of the Federal Reserve Bank of St. Louis . RePEc uses bibliographic data supplied by the respective publishers.