Competition, Gatekeeping, and Health Care Access
Geir Godager (),
Tor Iversen () and
Ching-to Ma ()
No 2013-011, Boston University - Department of Economics - Working Papers Series from Boston University - Department of Economics
We study gatekeeping physiciansiÌ referrals of patients to specialty care. We derive two theoret- ical results when competition in the physician market intensiOÌˆes. First, physicians refer patients to specialty care more often due to competitive pressure. Second, physicians earn more by treat- ing patients themselves, so refer patients to specialty care less often. We assess empirically the overall eÂ§ect of competition with data from a Norwegian survey in 2008-9 and Statistics Norway. From the data we construct three measures of competition: the number of open primary physician practices with and without population adjustment, and the HerOÌˆndahl-Hirschman Index. The em- pirical results suggest that competition has negligible or small positive eÂ§ects on referrals overall. Our results do not support the policy claim that increasing the number of primary care physicians reduces secondary care.
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http://www.bu.edu/econ/files/2014/05/Ma-Competitio ... -Access-May-2013.pdf First version, 2013 (application/pdf)
Journal Article: Competition, gatekeeping, and health care access (2015)
Working Paper: Competition, Gatekeeping, and Health Care Access (2012)
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Persistent link: https://EconPapers.repec.org/RePEc:bos:wpaper:wp2013-011
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