IDEAS home Printed from https://ideas.repec.org/p/hhs/oslohe/2020_004.html
   My bibliography  Save this paper

Technology Adoption in Primary Health Care

Author

Listed:
  • Iversen, Tor

    (Department of Health Management and Health Economics, University of Oslo)

  • Ching-to , Albert Ma

    (Department of Economics, Boston University)

Abstract

We study primary care physicians’ prevention and monitoring technology adoption. Physicians are assumed to decide to adopt based on benefits and costs, which depend on payment incentives, educational assistance, and market characteristics. The empirical study uses national Norwegian register and physician claims data between 2009 and 2014. In 2006, a new annual comprehensive checkup for Type 2 diabetic patients was introduced. A physician collects a fee for each checkup. In 2013, an education assistance program was introduced in two Norwegian counties. We estimate adoption decisions by two-part and fixed-effect regressions, and hazard models. We use a difference-in-difference model to estimate the education program impact. Adoptions are positively associated with a physician’s number of diabetic patients, and the fraction of physician-adopters in the same market. Fixed-effect estimations and separate analyses of physicians who have moved between municipalities causally support a peer effect. The education program has a strongly positive effect.

Suggested Citation

  • Iversen, Tor & Ching-to , Albert Ma, 2020. "Technology Adoption in Primary Health Care," HERO Online Working Paper Series 2020:4, University of Oslo, Health Economics Research Programme.
    • Handle: RePEc:hhs:oslohe:2020_004
    as

    Download full text from publisher

    File URL: https://www.med.uio.no/helsam/forskning/nettverk/hero/publikasjoner/skriftserie/2020/2020-4.pdf
    File Function: Full text
    Download Restriction: no
    ---><---

    References listed on IDEAS

    as
    1. Jill R. Horwitz & Charleen Hsuan & Austin Nichols, 2018. "The Role of Hospital and Market Characteristics in Invasive Cardiac Service Diffusion," Review of Industrial Organization, Springer;The Industrial Organization Society, vol. 53(1), pages 81-115, August.
    2. Iversen, Tor & Lurås, Hilde, 2011. "Patient switching in general practice," Journal of Health Economics, Elsevier, vol. 30(5), pages 894-903.
    3. Patrick Royston & Paul C. Lambert, 2011. "Flexible Parametric Survival Analysis Using Stata: Beyond the Cox Model," Stata Press books, StataCorp LP, number fpsaus, March.
    4. L. F. Andrade & T. Rapp & C. Sevilla-Dedieu, 2018. "Quality of diabetes follow-up care and hospital admissions," International Journal of Health Economics and Management, Springer, vol. 18(2), pages 153-167, June.
    5. Baker, Laurence C., 2001. "Managed care and technology adoption in health care: evidence from magnetic resonance imaging," Journal of Health Economics, Elsevier, vol. 20(3), pages 395-421, May.
    6. David Molitor, 2018. "The Evolution of Physician Practice Styles: Evidence from Cardiologist Migration," American Economic Journal: Economic Policy, American Economic Association, vol. 10(1), pages 326-356, February.
    Full references (including those not matched with items on IDEAS)

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Tor Iversen & Ching‐to Albert Ma, 2022. "Technology adoption by primary care physicians," Health Economics, John Wiley & Sons, Ltd., vol. 31(3), pages 443-465, March.
    2. Barili, Emilia & Bertoli, Paola & Grembi, Veronica, 2021. "Fee equalization and appropriate health care," Economics & Human Biology, Elsevier, vol. 41(C).
    3. Daron Acemoglu & Amy Finkelstein, 2008. "Input and Technology Choices in Regulated Industries: Evidence from the Health Care Sector," Journal of Political Economy, University of Chicago Press, vol. 116(5), pages 837-880, October.
    4. Maynou, L. & McGuire, A. & Serra-Sastre, V., 2019. "Exploring the Impact of New Medical Technology on Workforce Planning," Working Papers 19/07, Department of Economics, City University London.
    5. Simonsen, Marianne & Skipper, Lars & Skipper, Niels & Thingholm, Peter Rønø, 2021. "Discontinuity in care: Practice closures among primary care providers and patient health care utilization," Journal of Health Economics, Elsevier, vol. 80(C).
    6. Jackson, Christopher, 2016. "flexsurv: A Platform for Parametric Survival Modeling in R," Journal of Statistical Software, Foundation for Open Access Statistics, vol. 70(i08).
    7. Kurt R. Brekke & Tor Helge Holmås & Karin Monstad & Odd Rune Straume, 2020. "How Does The Type of Remuneration Affect Physician Behavior?," American Journal of Health Economics, University of Chicago Press, vol. 6(1), pages 104-138.
    8. Godager, Geir & Iversen, Tor & Ma, Ching-to Albert, 2015. "Competition, gatekeeping, and health care access," Journal of Health Economics, Elsevier, vol. 39(C), pages 159-170.
    9. Joon Mahn Lee & Rahul Kapoor, 2017. "Complementarities and Coordination: Implications for Governance Mode and Performance of Multiproduct Firms," Organization Science, INFORMS, vol. 28(5), pages 931-946, October.
    10. Amy Finkelstein & Matthew Gentzkow & Dean Li & Heidi L. Williams, 2022. "What Drives Risky Prescription Opioid Use? Evidence from Migration," NBER Working Papers 30471, National Bureau of Economic Research, Inc.
    11. Laurence Baker & Joanne Spetz, 1999. "Managed Care and Medical Technology Growth," NBER Chapters, in: Frontiers in Health Policy Research, volume 2, pages 27-52, National Bureau of Economic Research, Inc.
    12. David Bardey & Denis Gromb & David Martimort & Jérôme Pouyet, 2020. "Controlling Sellers Who Provide Advice: Regulation and Competition," Journal of Industrial Economics, Wiley Blackwell, vol. 68(3), pages 409-444, September.
    13. Fadlon, Itzik & Van Parys, Jessica, 2020. "Primary care physician practice styles and patient care: Evidence from physician exits in Medicare," Journal of Health Economics, Elsevier, vol. 71(C).
    14. Amaral-Garcia, S.;, 2022. "Medical Device Companies and Doctors: Do their interactions affect medical treatments?," Health, Econometrics and Data Group (HEDG) Working Papers 22/10, HEDG, c/o Department of Economics, University of York.
    15. Patrick Royston, 2012. "Tools to simulate realistic censored survival-time distributions," Stata Journal, StataCorp LP, vol. 12(4), pages 639-654, December.
    16. Karine Lamiraud & Stephane Lhuillery, 2016. "Endogenous Technology Adoption and Medical Costs," Health Economics, John Wiley & Sons, Ltd., vol. 25(9), pages 1123-1147, September.
    17. Noori Akhtar-Danesh, 2015. "A Comparison of Modeling Scales in Flexible Parametric Models," 2015 Stata Conference 15, Stata Users Group.
    18. repec:hal:wpspec:info:hdl:2441/4jcok93a4m9d1qtc3vnp4bdefk is not listed on IDEAS
    19. Enoch Yi-Tung Chen & Yuliya Leontyeva & Chia-Ni Lin & Jung-Der Wang & Mark S. Clements & Paul W. Dickman, 2024. "Comparing Survival Extrapolation within All-Cause and Relative Survival Frameworks by Standard Parametric Models and Flexible Parametric Spline Models Using the Swedish Cancer Registry," Medical Decision Making, , vol. 44(3), pages 269-282, April.
    20. Freedman, Seth & Lin, Haizhen & Simon, Kosali, 2015. "Public health insurance expansions and hospital technology adoption," Journal of Public Economics, Elsevier, vol. 121(C), pages 117-131.
    21. Attema, Arthur E. & Galizzi, Matteo M. & Groß, Mona & Hennig-Schmidt, Heike & Karay, Yassin & L’Haridon, Olivier & Wiesen, Daniel, 2023. "The formation of physician altruism," Journal of Health Economics, Elsevier, vol. 87(C).

    More about this item

    Keywords

    primary care; technology; monitoring; incentives; education program;
    All these keywords.

    JEL classification:

    • I11 - Health, Education, and Welfare - - Health - - - Analysis of Health Care Markets
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health
    • O31 - Economic Development, Innovation, Technological Change, and Growth - - Innovation; Research and Development; Technological Change; Intellectual Property Rights - - - Innovation and Invention: Processes and Incentives

    NEP fields

    This paper has been announced in the following NEP Reports:

    Statistics

    Access and download statistics

    Corrections

    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:2020_004. See general information about how to correct material in RePEc.

    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.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with 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.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Kristi Brinkmann Lenander (email available below). General contact details of provider: https://edirc.repec.org/data/heuiono.html .

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

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.