Gatekeeping in health care

Detalhes bibliográficos
Autor(a) principal: Brekke, Kurt R.
Data de Publicação: 2007
Outros Autores: Nuscheler, Robert, Straume, Odd Rune
Tipo de documento: Artigo
Idioma: eng
Título da fonte: Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
Texto Completo: http://hdl.handle.net/1822/6828
Resumo: We study the competitive effects of restricting direct access to secondary care by gatekeeping, focusing on the informational role of general practitioners (GPs). In the secondary care market there are two hospitals choosing quality and specialization. Patients, who are ex ante uninformed, can consult a GP to receive an (imperfect) diagnosis and obtain information about the secondary care market. We show that hospital competition is amplified by higher GP attendance but dampened by improved diagnosing accuracy. Therefore, compulsory gatekeeping may result in excessive quality competition and too much specialization, unless the mismatch costs and the diagnosing accuracy are sufficiently high. Second-best price regulation makes direct regulation of GP consultation redundant, but will generally not implement first-best.
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spelling Gatekeeping in health careGatekeepingImperfect informationQuality competitionProduct differentiationPrice regulationSocial SciencesScience & TechnologyWe study the competitive effects of restricting direct access to secondary care by gatekeeping, focusing on the informational role of general practitioners (GPs). In the secondary care market there are two hospitals choosing quality and specialization. Patients, who are ex ante uninformed, can consult a GP to receive an (imperfect) diagnosis and obtain information about the secondary care market. We show that hospital competition is amplified by higher GP attendance but dampened by improved diagnosing accuracy. Therefore, compulsory gatekeeping may result in excessive quality competition and too much specialization, unless the mismatch costs and the diagnosing accuracy are sufficiently high. Second-best price regulation makes direct regulation of GP consultation redundant, but will generally not implement first-best.Elsevier B.V.Universidade do MinhoBrekke, Kurt R.Nuscheler, RobertStraume, Odd Rune2007-012007-01-01T00:00:00Zinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfhttp://hdl.handle.net/1822/6828eng"Journal of Health Economics". ISSN 0167-6296. 26:1 (Jan. 2007) 149-170.0167-629610.1016/j.jhealeco.2006.04.00416890313http://www.sciencedirect.com/science/journal/01676296info:eu-repo/semantics/openAccessreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAP2023-07-21T12:41:20Zoai:repositorium.sdum.uminho.pt:1822/6828Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-19T19:38:18.195294Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse
dc.title.none.fl_str_mv Gatekeeping in health care
title Gatekeeping in health care
spellingShingle Gatekeeping in health care
Brekke, Kurt R.
Gatekeeping
Imperfect information
Quality competition
Product differentiation
Price regulation
Social Sciences
Science & Technology
title_short Gatekeeping in health care
title_full Gatekeeping in health care
title_fullStr Gatekeeping in health care
title_full_unstemmed Gatekeeping in health care
title_sort Gatekeeping in health care
author Brekke, Kurt R.
author_facet Brekke, Kurt R.
Nuscheler, Robert
Straume, Odd Rune
author_role author
author2 Nuscheler, Robert
Straume, Odd Rune
author2_role author
author
dc.contributor.none.fl_str_mv Universidade do Minho
dc.contributor.author.fl_str_mv Brekke, Kurt R.
Nuscheler, Robert
Straume, Odd Rune
dc.subject.por.fl_str_mv Gatekeeping
Imperfect information
Quality competition
Product differentiation
Price regulation
Social Sciences
Science & Technology
topic Gatekeeping
Imperfect information
Quality competition
Product differentiation
Price regulation
Social Sciences
Science & Technology
description We study the competitive effects of restricting direct access to secondary care by gatekeeping, focusing on the informational role of general practitioners (GPs). In the secondary care market there are two hospitals choosing quality and specialization. Patients, who are ex ante uninformed, can consult a GP to receive an (imperfect) diagnosis and obtain information about the secondary care market. We show that hospital competition is amplified by higher GP attendance but dampened by improved diagnosing accuracy. Therefore, compulsory gatekeeping may result in excessive quality competition and too much specialization, unless the mismatch costs and the diagnosing accuracy are sufficiently high. Second-best price regulation makes direct regulation of GP consultation redundant, but will generally not implement first-best.
publishDate 2007
dc.date.none.fl_str_mv 2007-01
2007-01-01T00:00:00Z
dc.type.status.fl_str_mv info:eu-repo/semantics/publishedVersion
dc.type.driver.fl_str_mv info:eu-repo/semantics/article
format article
status_str publishedVersion
dc.identifier.uri.fl_str_mv http://hdl.handle.net/1822/6828
url http://hdl.handle.net/1822/6828
dc.language.iso.fl_str_mv eng
language eng
dc.relation.none.fl_str_mv "Journal of Health Economics". ISSN 0167-6296. 26:1 (Jan. 2007) 149-170.
0167-6296
10.1016/j.jhealeco.2006.04.004
16890313
http://www.sciencedirect.com/science/journal/01676296
dc.rights.driver.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
dc.publisher.none.fl_str_mv Elsevier B.V.
publisher.none.fl_str_mv Elsevier B.V.
dc.source.none.fl_str_mv reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação
instacron:RCAAP
instname_str Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação
instacron_str RCAAP
institution RCAAP
reponame_str Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
collection Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
repository.name.fl_str_mv Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação
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