GPs’ payment contracts and their referral practice

Begoña Mariñoso () and Izabela Jelovac
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Begoña Mariñoso: City University London

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Abstract: This paper compares the role of general practitioners in determining access to specialists in two types of health care systems: gate-keeping systems, where a general practitioner (GP) referral is compulsory to visit a specialist, and non-gate-keeping systems, where this referral is optional. We model the dependence between the GP's diagnosis effort and her referral behaviour, and identify the optimal contracts that induce the best behaviour from a public insurer's point of view, where there is asymmetry of information between the insurer and the GP regarding diagnosis effort and referral decisions. We show that gate keeping is superior wherever GP's incentives matter.

Keywords: health economics; referral; contracts and moral hazard (search for similar items in EconPapers)
Date: 2003
Note: View the original document on HAL open archive server: https://hal.science/hal-03881162v2
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Citations: View citations in EconPapers (4)

Published in Journal of Health Economics, 2003, 22 (4), pp.617 - 635. ⟨10.1016/s0167-6296(03)00008-0⟩

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Journal Article: GPs' payment contracts and their referral practice (2003)
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Persistent link: https://EconPapers.repec.org/RePEc:hal:journl:hal-03881162

DOI: 10.1016/s0167-6296(03)00008-0

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