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Technology Adoption in Primary Health Care

Author

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  • 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
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    References listed on IDEAS

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    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. 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.
    3. 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.
    4. 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.
    5. Iversen, Tor & Lurås, Hilde, 2011. "Patient switching in general practice," Journal of Health Economics, Elsevier, vol. 30(5), pages 894-903.
    6. Patrick Royston & Paul C. Lambert, 2011. "Flexible Parametric Survival Analysis Using Stata: Beyond the Cox Model," Stata Press books, StataCorp LLC, number fpsaus, December.
    7. Anthony Scott & Stefanie Schurer & Paul H. Jensen & Peter Sivey, 2009. "The effects of an incentive program on quality of care in diabetes management," Health Economics, John Wiley & Sons, Ltd., vol. 18(9), pages 1091-1108, September.
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    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

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