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The Physician-Patient Relationship Revisited - the Patient's View

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  • Udo Schneider

    (University of Bayreuth)

  • Volker Ulrich

    (University of Bayreuth)

Abstract

The importance of the physician-patient relationship for the health care market is beyond controversy. Most theoretical work is done in a principal-agent framework, dealing with moral hazard problems. Recent work emphasizes a two-sided asymmetric information relationship between physician and patient (double moral hazard). In contrast to most work looking only at the physician's perspectives, our paper concentrates on the patient's view. Estimation results using panel data support the hypotheses that physician consultation and health-relevant behavior are not stochastically independent. This means that health care demand is determined by the patient and not only by the physician. In the recursive bivariate probit model, the patient’s health-relevant behavior has a significant positive influence on the probability of a physician visit. This should be taken into account in the discussion that primary care physicians should function as gatekeepers.

Suggested Citation

  • Udo Schneider & Volker Ulrich, 2005. "The Physician-Patient Relationship Revisited - the Patient's View," HEW 0505001, University Library of Munich, Germany.
  • Handle: RePEc:wpa:wuwphe:0505001
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    1. William Greene, 2001. "Fixed and Random Effects in Nonlinear Models," Working Papers 01-01, New York University, Leonard N. Stern School of Business, Department of Economics.
    2. Gaynor, Martin, 1994. "Issues in the Industrial Organization of the Market for Physician Services," Journal of Economics & Management Strategy, Wiley Blackwell, vol. 3(1), pages 211-255, Spring.
    3. Holly, Alberto & Gardiol, Lucien & Domenighetti, Gianfranco & Brigitte Bisig, 1998. "An econometric model of health care utilization and health insurance in Switzerland," European Economic Review, Elsevier, vol. 42(3-5), pages 513-522, May.
    4. William Greene, 2004. "Convenient estimators for the panel probit model: Further results," Empirical Economics, Springer, vol. 29(1), pages 21-47, January.
    5. McGuire, Thomas G., 2000. "Physician agency," Handbook of Health Economics, in: A. J. Culyer & J. P. Newhouse (ed.), Handbook of Health Economics, edition 1, volume 1, chapter 9, pages 461-536, Elsevier.
    6. Balia, Silvia & Jones, Andrew M., 2008. "Mortality, lifestyle and socio-economic status," Journal of Health Economics, Elsevier, vol. 27(1), pages 1-26, January.
    7. Mandy Ryan, 1994. "Agency in Health Care: Lessons for Economists from Sociologists," American Journal of Economics and Sociology, Wiley Blackwell, vol. 53(2), pages 207-217, April.
    8. Laura Greene Knapp & Terry Seaks, 1998. "A Hausman test for a dummy variable in probit," Applied Economics Letters, Taylor & Francis Journals, vol. 5(5), pages 321-323.
    9. Russell Cooper & Thomas W. Ross, 1985. "Product Warranties and Double Moral Hazard," RAND Journal of Economics, The RAND Corporation, vol. 16(1), pages 103-113, Spring.
    10. Winand Emons, 1997. "Credence Goods and Fraudelent Experts," RAND Journal of Economics, The RAND Corporation, vol. 28(1), pages 107-119, Spring.
    11. Grossman, Michael, 1972. "On the Concept of Health Capital and the Demand for Health," Journal of Political Economy, University of Chicago Press, vol. 80(2), pages 223-255, March-Apr.
    12. Ma, Ching-to Albert & McGuire, Thomas G, 1997. "Optimal Health Insurance and Provider Payment," American Economic Review, American Economic Association, vol. 87(4), pages 685-704, September.
    13. William H. Greene, 1998. "Gender Economics Courses in Liberal Arts Colleges: Further Results," The Journal of Economic Education, Taylor & Francis Journals, vol. 29(4), pages 291-300, January.
    14. D. Fabbri & C. Monfardini & R. Radice, 2004. "Testing exogeneity in the bivariate probit model: Monte Carlo evidence and an application to health economics," Working Papers 514, Dipartimento Scienze Economiche, Universita' di Bologna.
    15. Andrew M. Jones, 2012. "health econometrics," The New Palgrave Dictionary of Economics,, Palgrave Macmillan.
    16. Udo Schneider, 2004. "Asymmetric Information and the Demand for Health Care – the Case of Double Moral Hazard," Schmollers Jahrbuch : Journal of Applied Social Science Studies / Zeitschrift für Wirtschafts- und Sozialwissenschaften, Duncker & Humblot, Berlin, vol. 124(2), pages 233-256.
    17. A. J. Culyer & J. P. Newhouse (ed.), 2000. "Handbook of Health Economics," Handbook of Health Economics, Elsevier, edition 1, volume 1, number 1.
    18. Robert G. Evans, 1974. "Supplier-Induced Demand: Some Empirical Evidence and Implications," International Economic Association Series, in: Mark Perlman (ed.), The Economics of Health and Medical Care, chapter 10, pages 162-173, Palgrave Macmillan.
    19. Knaus, Thomas & Nuscheler, Robert, 2002. "Incomplete risk adjustment and adverse selection in the German public health insurance system [Unvollständiger Risikostrukturausgleich und Adverse Selektion in der Gesetzlichen Krankenversicherung ," Discussion Papers, Research Unit: Market Processes and Governance FS IV 02-27, WZB Berlin Social Science Center.
    20. Udo Schneider, 2002. "Beidseitige Informationsasymmetrien in der Arzt-Patient-Beziehung: Implikationen für die GKV," Vierteljahrshefte zur Wirtschaftsforschung / Quarterly Journal of Economic Research, DIW Berlin, German Institute for Economic Research, vol. 71(4), pages 447-458.
    21. William Greene, 2003. "A Interpreting Estimated Parameters and Measuring Individual Heterogeneity in Random Coefficient Models," Working Papers 03-19, New York University, Leonard N. Stern School of Business, Department of Economics.
    22. Wilde, Joachim, 2000. "Identification of multiple equation probit models with endogenous dummy regressors," Economics Letters, Elsevier, vol. 69(3), pages 309-312, December.
    23. Zweifel, Peter & Manning, Willard G., 2000. "Moral hazard and consumer incentives in health care," Handbook of Health Economics, in: A. J. Culyer & J. P. Newhouse (ed.), Handbook of Health Economics, edition 1, volume 1, chapter 8, pages 409-459, Elsevier.
    24. Winfried Pohlmeier & Volker Ulrich, 1995. "An Econometric Model of the Two-Part Decisionmaking Process in the Demand for Health Care," Journal of Human Resources, University of Wisconsin Press, vol. 30(2), pages 339-361.
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    Cited by:

    1. Schmid, Andreas, 2007. "Incentive Compatibility and Efficiency in the contractual Insurer-Provider Relationship: Economic Theory and practical Implications: The Case of North Carolina," MPRA Paper 23311, University Library of Munich, Germany, revised 2008.
    2. Fichera, Eleonora & Emsley, Richard & Sutton, Matt, 2016. "Is treatment “intensity” associated with healthier lifestyle choices? An application of the dose response function," Economics & Human Biology, Elsevier, vol. 23(C), pages 149-163.
    3. Till Bärnighausen & David E. Bloom, 2009. "Changing Research Perspectives on the Global Health Workforce," NBER Working Papers 15168, National Bureau of Economic Research, Inc.
    4. Abraham Abebe Asfaw, 2019. "The effect of prescription drug insurance on health behavior: Evidence from Medicare Part D," Health Economics, John Wiley & Sons, Ltd., vol. 28(3), pages 403-418, March.
    5. Eleonora Fichera & James Banks & Matt Sutton, 2014. "Health behaviours and the patient-doctor interaction: The double moral hazard problem," Economics Discussion Paper Series 1415, Economics, The University of Manchester.
    6. Fichera, Eleonora & Gray, Ewan & Sutton, Matt, 2016. "How do individuals’ health behaviours respond to an increase in the supply of health care? Evidence from a natural experiment," Social Science & Medicine, Elsevier, vol. 159(C), pages 170-179.
    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

    physician-patient relationship; health behavior; bivariate probit;
    All these keywords.

    JEL classification:

    • I11 - Health, Education, and Welfare - - Health - - - Analysis of Health Care Markets
    • C33 - Mathematical and Quantitative Methods - - Multiple or Simultaneous Equation Models; Multiple Variables - - - Models with Panel Data; Spatio-temporal Models
    • D82 - Microeconomics - - Information, Knowledge, and Uncertainty - - - Asymmetric and Private Information; Mechanism Design

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