Information Asymmetry, Insurance, and the Decision to Hospitalize

Ake Blomqvist and Pierre Leger

CIRANO Working Papers from CIRANO

Abstract: In a theoretical model, we analyze the effects of various kinds of demand- and supply-side incentives in the context of a model in which patients and doctors must decide not only on an aggregate quantity of health services to use in treating various kinds of illness, but also have a choice between different kinds of providers (in particular, outpatient services rendered by primary-care physicians or inpatient services provided by hospital-based specialists). We present two broad models, the traditional fee-for-service payment scheme and a managed care setup where physicians are paid via capitation, and analyze them both with and without information asymmetry. We find that under certain plausible conditions, second-best optimal managed care plans may dominate second-best optimal conventional plans that rely on cost control through demand-side cost sharing. À l'aide d'un modèle théorique dans lequel patients et médecins doivent choisir la quantité de service à utiliser ainsi que celui, de l'omnipraticien ou du spécialiste uvrant à l'hôpital, qui fournira ces services, nous analysons différents mécanismes d'incitation agissant sur l'offre et la demande. Nous étudions essentiellement deux modes d'organisation : le système conventionnel de rémunération à l'acte et le système de gestion intégrée des soins avec une rémunération per capita; à la fois en présence et en l'absence d'asymétrie d'information. Nous obtenons comme résultat qu'à certaines conditions plausibles, l'optimum de second-rang auquel mène le système de gestion intégrée est supérieur à celui que donne le système conventionnel de rémunération à l'acte qui répercute une partie des coûts sur l'utilisateur.

Keywords: Primary Care; Specialty Care; Hospitalization; Insurance; HMOs; Capitation; Asymmetric Information; Omnipraticiens; Spécialistes; Hospitalisation; Assurance; Paiements à l'acte et per capita; Asymétrie d'information (search for similar items in EconPapers)
JEL-codes: I1 (search for similar items in EconPapers)
Date: 2002-01-01
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https://cirano.qc.ca/files/publications/2002s-06.pdf

Related works:
Journal Article: Information asymmetry, insurance, and the decision to hospitalize (2005)
Working Paper: Information Asymmetry, Insurance, and the Decision to Hospitalize (2001)
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Persistent link: https://EconPapers.repec.org/RePEc:cir:cirwor:2002s-06

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