Competition, Gatekeeping, and Health Care Access
We study the impact of competition on primary care physicians’specialty referrals. Our data come from a Norwegian survey in 2008-9 and Statistics Norway. From the data we construct three measures of competition the number of open primary physician practices with and without population adjustment, and the Her…ndahl-Hirschman Index. We build a theoretical model, and derive two opposing e¤ects of competition on gatekeeping physicians’ specialty referrals. The empirical results suggest that competition has negligible or small positive e¤ects on referrals. Our results do not support the policy claim that increasing the number of primary care physicians reduces secondary care.
|Date of creation:||01 Aug 2012|
|Date of revision:|
|Contact details of provider:|| Postal: |
Phone: 2307 5309
Fax: 2307 5310
Web page: http://www.hero.uio.no/eng.html
More information through EDIRC
Please report citation or reference errors to , or , if you are the registered author of the cited work, log in to your RePEc Author Service profile, click on "citations" and make appropriate adjustments.:
- Wright, David Bradley & Ricketts III, Thomas C., 2010. "The road to efficiency? Re-examining the impact of the primary care physician workforce on health care utilization rates," Social Science & Medicine, Elsevier, vol. 70(12), pages 2006-2010, June.
- Ching-to Albert MA & Tor Iversen, 2010.
"Market conditions and general practitioners’ referrals,"
Boston University - Department of Economics - Working Papers Series
WP2010-023, Boston University - Department of Economics.
- Tor Iversen & Ching-to Ma, 2011. "Market conditions and general practitioners’ referrals," International Journal of Health Care Finance and Economics, Springer, vol. 11(4), pages 245-265, December.
- Iversen, Tor & Ma, Albert, 2009. "Market Conditions and General Practitioners’ Referrals," HERO On line Working Paper Series 2009:8, Oslo University, Health Economics Research Programme.
- Tor Iversen & Ching-to Albert Ma, . "Market Conditions and General Practitioners' Referrals," Boston University - Department of Economics - Working Papers Series wp2009-009, Boston University - Department of Economics.
- Pau Olivella Cunill & Pedro Pita Barros, 2000.
"Waiting Lists and Patient Selection,"
Econometric Society World Congress 2000 Contributed Papers
0283, Econometric Society.
- Barros, Pedro Luis Pita, 2000. "Waiting Lists and Patient Selection," CEPR Discussion Papers 2519, C.E.P.R. Discussion Papers.
- Pedro Pita Barros & Pau Olivella, . "Waiting Lists And Patient Selection," UFAE and IAE Working Papers 444.99, Unitat de Fonaments de l'Anàlisi Econòmica (UAB) and Institut d'Anàlisi Econòmica (CSIC).
- Chen, Xing & Godager, Geir, 2011. "Development of competition indicators in the Norwegian general practice: Constructing a postal code-specific Herfindahl-Hirschman index applying STATA software," HERO On line Working Paper Series 2011:1, Oslo University, Health Economics Research Programme.
- Dranove, David & Wehner, Paul, 1994. "Physician-induced demand for childbirths," Journal of Health Economics, Elsevier, vol. 13(1), pages 61-73, March.
- Atella, Vincenzo & Deb, Partha, 2008. "Are primary care physicians, public and private sector specialists substitutes or complements? Evidence from a simultaneous equations model for count data," Journal of Health Economics, Elsevier, vol. 27(3), pages 770-785, May.
- Tor Iversen & Gry Stine Kopperud, 2005.
"Regulation versus practice - the impact of accessibility on the use of specialist health care in Norway,"
John Wiley & Sons, Ltd., vol. 14(12), pages 1231-1238.
- Iversen, Tor & Kopperud, Gry Stine, 2009. "Regulation versus practice - The impact of accessibility on the use of specialist health care in Norway," HERO On line Working Paper Series 2005:2, Oslo University, Health Economics Research Programme.
- Iversen, Tor & Lurås, Hilde, 2011. "Patient switching in general practice," Journal of Health Economics, Elsevier, vol. 30(5), pages 894-903.
- Mark V. Pauly, 2004. "Competition in Medical Services and the Quality of Care: Concepts and History," International Journal of Health Care Finance and Economics, Springer, vol. 4(2), pages 113-130, 06.
- Katherine Baicker & Amitabh Chandra, 2004. "The Productivity of Physician Specialization: Evidence from the Medicare Program," American Economic Review, American Economic Association, vol. 94(2), pages 357-361, May.
- Marie Allard & Izabela Jelovac & Pierre-Thomas Léger, 2011.
"Treatment and referral decisions under different physician payment mechanisms,"
- Allard, Marie & Jelovac, Izabela & Léger, Pierre Thomas, 2011. "Treatment and referral decisions under different physician payment mechanisms," Journal of Health Economics, Elsevier, vol. 30(5), pages 880-893.
When requesting a correction, please mention this item's handle: RePEc:hhs:oslohe:2012_002. 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: (Anbjørg Kolaas)
If references are entirely missing, you can add them using this form.