Competition and physician behaviour: Does the competitive environment affect the propensity to issue sickness certificates?

Kurt Brekke (), Tor Helge Holmås, Karin Monstad and Odd Rune Straume

Journal of Health Economics, 2019, vol. 66, issue C, 117-135

Abstract: Competition among physicians is widespread, but compelling empirical evidence on its impact on service provision is limited, mainly due to endogeneity issues. In this paper we exploit that many GPs, in addition to own practice, work in local emergency centres, where the matching of patients to GPs is random. The same GP is observed both with competition (own practice) and without (emergency centre). Using high-dimensional fixed-effect models, we find that GPs with a fee-for-service (fixed-salary) contract are 12 (8) percentage points more likely to certify sick leave at own practice than at the emergency centre. Thus, competition has a positive impact on GPs’ sicklisting that is strongly reinforced by financial incentives.

Keywords: Physicians; Competition; Sickness certification (search for similar items in EconPapers)
JEL-codes: I11 I18 L13 (search for similar items in EconPapers)
Date: 2019
References: View references in EconPapers View complete reference list from CitEc
Citations: View citations in EconPapers (5)

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Working Paper: Competition and Physician Behaviour: Does the Competitive Environment Affect the Propensity to Issue Sickness Certificates? (2017)
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Persistent link: https://EconPapers.repec.org/RePEc:eee:jhecon:v:66:y:2019:i:c:p:117-135

DOI: 10.1016/j.jhealeco.2019.05.007

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