Gatekeeping in Health Care

Kurt Brekke (kurt.brekke@nhh.no), Robert Nuscheler and Odd Rune Straume

No 1552, CESifo Working Paper Series from CESifo

Abstract: We study the competitive effects of restricting direct access to secondary care by gatekeeping, focusing on the informational role of general practitioners (GPs). In the secondary care market there are two hospitals choosing quality and specialisation. Patients, who are ex ante uninformed, can consult a GP to receive an (imperfect) diagnosis and obtain information about the secondary care market. We show that hospital competition is amplified by higher GP attendance but dampened by improved diagnosing accuracy. Therefore, compulsory gatekeeping may result in excessive quality competition and too much specialisation, unless the mismatch costs and the diagnosing accuracy are sufficiently high. Second-best price regulation makes direct regulation of GP consultation redundant, but will generally not implement first-best.

Keywords: gatekeeping; imperfect information; quality competition; product differentiation; price regulation (search for similar items in EconPapers)
JEL-codes: D82 I11 I18 L13 (search for similar items in EconPapers)
Date: 2005
New Economics Papers: this item is included in nep-hea and nep-mic
References: View references in EconPapers View complete reference list from CitEc
Citations: View citations in EconPapers (2)

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Related works:
Journal Article: Gatekeeping in health care (2007)
Working Paper: Gatekeeping In Health Care (2004)
Working Paper: Gatekeeping in health care (2003)
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Persistent link: https://EconPapers.repec.org/RePEc:ces:ceswps:_1552

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