Managing Demand in Primary Care: The Market for Night Visits
We analyse the demand for and the supply of night visits in primary care. A model of demand management by general practitioners and of their choice between meeting demand by making visits themselves or passing them to commercial deputising services is presented. Demand and supply equations are derived and estimated using panel data from English primary care health authorities over the 1984-1994 period. The introduction of differential fees for GP and deputy visits in April 1990 led GPs to increase their own visits and to reduce the number made by deputies. GPs also responded by either reducing efforts to manage demand downwards or increasing efforts to induce demand. GPs manage demand downwards in response to exogenous demand increases. We also find that demand is not affected by the likelihood that the visit is made by a GP or a deputy, suggesting that patients do not perceive these visits as being of differential quality.
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