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The market for paid sick leave

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  • Markussen, Simen
  • Røed, Knut

Abstract

In many countries, general practitioners (GPs) are assigned the task of controlling the validity of their own patients’ insurance claims. At the same time, they operate in a market where patients are customers free to choose their GP. Are these roles compatible? Can we trust that the gatekeeping decisions are untainted by private economic interests? Based on administrative registers from Norway with records on sick pay certification and GP-patient relationships, we present evidence to the contrary: GPs are more lenient gatekeepers the more competitive is the physician market, and a reputation for lenient gatekeeping increases the demand for their services.

Suggested Citation

  • Markussen, Simen & Røed, Knut, 2017. "The market for paid sick leave," Journal of Health Economics, Elsevier, vol. 55(C), pages 244-261.
    • Handle: RePEc:eee:jhecon:v:55:y:2017:i:c:p:244-261
    DOI: 10.1016/j.jhealeco.2017.07.008
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    1. Brekke, Kurt R. & Holmås, Tor Helge & Monstad, Karin & Straume, Odd Rune, 2019. "Competition and physician behaviour: Does the competitive environment affect the propensity to issue sickness certificates?," Journal of Health Economics, Elsevier, vol. 66(C), pages 117-135.
    2. Beckert, Walter, 2018. "Choice in the presence of experts: The role of general practitioners in patients’ hospital choice," Journal of Health Economics, Elsevier, vol. 60(C), pages 98-117.
    3. Simonsen, Marianne & Skipper, Lars & Skipper, Niels & Thingholm, Peter Rønø, 2021. "Discontinuity in care: Practice closures among primary care providers and patient health care utilization," Journal of Health Economics, Elsevier, vol. 80(C).
    4. Hernæs, Øystein, 2018. "Activation against absenteeism – Evidence from a sickness insurance reform in Norway," Journal of Health Economics, Elsevier, vol. 62(C), pages 60-68.
    5. Francisco Gomez Martinez & Sander Onderstal & Maarten Pieter Schinkel, 2019. "Can Collusion Promote Corporate Social Responsibility? Evidence from the Lab," Tinbergen Institute Discussion Papers 19-034/VII, Tinbergen Institute, revised 12 Nov 2019.
    6. Jens Dietrichson & Lina Maria Ellegård & Gustav Kjellsson, 2020. "Patient choice, entry, and the quality of primary care: Evidence from Swedish reforms," Health Economics, John Wiley & Sons, Ltd., vol. 29(6), pages 716-730, June.
    7. Carlo Alberto Biscardo & Alessandro Bucciol & Paolo Pertile, 2019. "Job sick leave: Detecting opportunistic behavior," Health Economics, John Wiley & Sons, Ltd., vol. 28(3), pages 373-386, March.
    8. Pichler, Stefan & Ziebarth, Nicolas R., 2024. "Sick Leave and Medical Leave in the United States: A Categorization and Recent Trends," IZA Policy Papers 206, Institute of Labor Economics (IZA).
    9. Emilia Simeonova & Niels Skipper & Peter R. Thingholm, 2020. "Physician Health Management Skills and Patient Outcomes," NBER Working Papers 26735, National Bureau of Economic Research, Inc.
    10. Godøy, Anna & Dale-Olsen, Harald, 2018. "Spillovers from gatekeeping – Peer effects in absenteeism," Journal of Public Economics, Elsevier, vol. 167(C), pages 190-204.
    11. Benedicte Carlsen & Jo Thori Lind & Karine Nyborg, 2020. "Why physicians are lousy gatekeepers: Sicklisting decisions when patients have private information on symptoms," Health Economics, John Wiley & Sons, Ltd., vol. 29(7), pages 778-789, July.
    12. Brekke, Kurt R. & Holmås, Tor Helge & Monstad, Karin & Straume, Odd Rune, 2017. "Competition and physician behaviour: Does the competitive environment the propensity to issue sickness certificates?," Discussion Paper Series in Economics 3/2017, Norwegian School of Economics, Department of Economics.
    13. Adrienne Ohler & Adam Thorp, 2023. "A model of accrual rates for paid sick leave mandates," Economics Bulletin, AccessEcon, vol. 43(2), pages 769-783.
    14. Peter Rønø Thingholm, 2023. "Provider Spill-Overs in Opioid Prescription Leniency and Patient – Labor Market Outcomes," Economics Working Papers 2023-05, Department of Economics and Business Economics, Aarhus University.
    15. Willén, Alexander & Willage, Barton & Riise, Julie, 2022. "Employment Protection and Child Development," Discussion Paper Series in Economics 19/2022, Norwegian School of Economics, Department of Economics.
    16. Cronin, C.J.; & Harris, M. C.; & Ziebarth, N. R.;, 2024. "The Anatomy of U.S. Sick Leave Schemes:Evidence from Public School Teachers," Health, Econometrics and Data Group (HEDG) Working Papers 24/10, HEDG, c/o Department of Economics, University of York.

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    More about this item

    Keywords

    Absenteeism; Gatekeeping; Competition; Role-conflicts;
    All these keywords.

    JEL classification:

    • H55 - Public Economics - - National Government Expenditures and Related Policies - - - Social Security and Public Pensions
    • I11 - Health, Education, and Welfare - - Health - - - Analysis of Health Care Markets
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health

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