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Cut off from new competition: Threat of entry and quality of primary care

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  • Brüll, Eduard
  • Rostam-Afschar, Davud
  • Schlenker, Oliver

Abstract

We study how the threat of entry affects service quantity and quality of general practitioners (GPs). We leverage Germany’s needs-based primary care planning system, in which the likelihood of new GPs reduces by 20 percentage points when primary care coverage exceeds a cut-off. We compile novel data covering all German primary care regions and up to 30,000 GP-level observations from 2014 to 2019. Reduced threat of entry lowers patient satisfaction for incumbent GPs without nearby competitors but not in areas with competitors. We find no effects on working hours or quality measures at the regional level including hospitalizations and mortality.

Suggested Citation

  • Brüll, Eduard & Rostam-Afschar, Davud & Schlenker, Oliver, 2025. "Cut off from new competition: Threat of entry and quality of primary care," Labour Economics, Elsevier, vol. 92(C).
    • Handle: RePEc:eee:labeco:v:92:y:2025:i:c:s0927537124001659
    DOI: 10.1016/j.labeco.2024.102669
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    More about this item

    Keywords

    Entry regulation; General practitioners; Healthcare provision; Threat of entry; Regression discontinuity design;
    All these keywords.

    JEL classification:

    • I11 - Health, Education, and Welfare - - Health - - - Analysis of Health Care Markets
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health
    • J44 - Labor and Demographic Economics - - Particular Labor Markets - - - Professional Labor Markets and Occupations
    • J22 - Labor and Demographic Economics - - Demand and Supply of Labor - - - Time Allocation and Labor Supply
    • L10 - Industrial Organization - - Market Structure, Firm Strategy, and Market Performance - - - General
    • L22 - Industrial Organization - - Firm Objectives, Organization, and Behavior - - - Firm Organization and Market Structure
    • R23 - Urban, Rural, Regional, Real Estate, and Transportation Economics - - Household Analysis - - - Regional Migration; Regional Labor Markets; Population

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