Gatekeeping in health care

Kurt Brekke () and Robert Nuscheler

No 10/03, Working Papers in Economics from University of Bergen, Department of Economics

Abstract: We study the competitive effects of restricting direct access to secondary care by gatekeeping, focusing on the informational role of gatekeeping general practitioners (GPs). We consider a secondary care market with two hospitals choosing the quality and specialisation of their care. GPs perfectly observe the diagnosis of a patient and the exact characteristics of the secondary care market. Patients are either informed or uninformed when accessing the hospital market. We consider two distinct cases: first, we let the fraction of informed patients be exogenous, implying that the regulator can only influence patients' decision of consulting a GP by making this compulsory ('direct gatekeeping'). Second, we endogenise this fraction by assuming GP consultation to be costly for the patient. Then the reulator can influence the GP attendance rate through the regulated price ('indirect gatekeeping'). A main finding of the paper is that strict gatekeeping may not be socially desirable, even if it is costless.

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)
Pages: 28 pages
Date: 2003-07-04
References: Add references at 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 (2005)
Working Paper: Gatekeeping In Health Care (2004)
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Persistent link: https://EconPapers.repec.org/RePEc:hhs:bergec:2003_010

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