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The effect of capitation on GPs' referral decisions

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  • Tor Iversen
  • Hilde Lurås

Abstract

In the Norwegian capitation trial, the payment system for general practitioners (GPs) has been changed; a practice allowance component has been replaced by a capitation component and the fee‐per‐item component constitutes a smaller part of a GPs practice income than previously. From the theoretical modelling of GPs' referral decisions, we predict that the replacement of the practice allowance by a capitation component will increase the rate of referrals to specialists. This hypothesis is supported by an exploratory empirical study with data from a sample of GPs participating in the experiment. Copyright © 2000 John Wiley & Sons, Ltd.

Suggested Citation

  • Tor Iversen & Hilde Lurås, 2000. "The effect of capitation on GPs' referral decisions," Health Economics, John Wiley & Sons, Ltd., vol. 9(3), pages 199-210, April.
    • Handle: RePEc:wly:hlthec:v:9:y:2000:i:3:p:199-210
    DOI: 10.1002/(SICI)1099-1050(200004)9:3<199::AID-HEC514>3.0.CO;2-2
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    References listed on IDEAS

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    1. B Hutchison & S Birch & J Hurley & J Lomas & F Stratford-Devai, 1994. "Do Physician Payment Mechanisms Affect Hospital Utilization? A Study of Health Service Organizations in Ontario," Centre for Health Economics and Policy Analysis Working Paper Series 1994-02, Centre for Health Economics and Policy Analysis (CHEPA), McMaster University, Hamilton, Canada.
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    Cited by:

    1. Griebenow, Malte & Kifmann, Mathias, 2021. "Diagnostics and treatment: On the division of labor between primary care physicians and specialists," hche Research Papers 25, University of Hamburg, Hamburg Center for Health Economics (hche).
    2. Quinn, Amity E. & Trachtenberg, Aaron J. & McBrien, Kerry A. & Ogundeji, Yewande & Souri, Sepideh & Manns, Liam & Rennert-May, Elissa & Ronksley, Paul & Au, Flora & Arora, Nikita & Hemmelgarn, Brenda , 2020. "Impact of payment model on the behaviour of specialist physicians: A systematic review," Health Policy, Elsevier, vol. 124(4), pages 345-358.
    3. Iversen, Tor & Kopperud, Gry Stine, 2009. "The impact of accessibility on the use of specialist health care in Norway," HERO Online Working Paper Series 2002:9, University of Oslo, Health Economics Research Programme.
    4. Tor Iversen & Ching-to Ma, 2011. "Market conditions and general practitioners’ referrals," International Journal of Health Economics and Management, Springer, vol. 11(4), pages 245-265, December.
    5. Marie Allard & Izabela Jelovac & Pierre-Thomas Léger, 2014. "Payment mechanism and GP self-selection: capitation versus fee for service," International Journal of Health Economics and Management, Springer, vol. 14(2), pages 143-160, June.
    6. Lurås, Hilde, 2009. "General Practice: Four Empirical Essays on GP Behaviour and Individuals’ Preferences for GPs," HERO Online Working Paper Series 2004:1, University of Oslo, Health Economics Research Programme.
    7. Marisol Rodríguez & Alexandrina Stoyanova, 2004. "The effect of private insurance access on the choice of GP/specialist and public/private provider in Spain," Health Economics, John Wiley & Sons, Ltd., vol. 13(7), pages 689-703, July.
    8. Kjeld Møller Pedersen & Terkel Christiansen & Mickael Bech, 2005. "The Danish health care system: evolution ‐ not revolution ‐ in a decentralized system," Health Economics, John Wiley & Sons, Ltd., vol. 14(S1), pages 41-57, September.
    9. Cox, James C. & Sadiraj, Vjollca & Schnier, Kurt E. & Sweeney, John F., 2016. "Incentivizing cost-effective reductions in hospital readmission rates," Journal of Economic Behavior & Organization, Elsevier, vol. 131(PB), pages 24-35.
    10. Iversen, Tor & Lurås, Hilde, 2009. "The importance of micro-data for revaealing income motivated behaviour among GPs," HERO Online Working Paper Series 1999:3, University of Oslo, Health Economics Research Programme.
    11. Tor Iversen & Hilde Lurås, 2012. "Capitation and Incentives in Primary Care," Chapters, in: Andrew M. Jones (ed.), The Elgar Companion to Health Economics, Second Edition, chapter 26, Edward Elgar Publishing.
    12. Christel Dijk & Robert Verheij & Hans te Brake & Peter Spreeuwenberg & Peter Groenewegen & Dinny Bakker, 2014. "Changes in the remuneration system for general practitioners: effects on contact type and consultation length," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 15(1), pages 83-91, January.
    13. Himmel, Konrad & Schneider, Udo, 2017. "Ambulatory care at the end of a billing period," hche Research Papers 14, University of Hamburg, Hamburg Center for Health Economics (hche).
    14. Li, JingJing & Godager, Geir & Wang, Jian, 2016. "Does physician gender influence the provision of medical care? An experimental study," HERO Online Working Paper Series 2016:6, University of Oslo, Health Economics Research Programme.
    15. Sveréus, Sofia & Kjellsson, Gustav & Rehnberg, Clas, 2018. "Socioeconomic distribution of GP visits following patient choice reform and differences in reimbursement models: Evidence from Sweden," Health Policy, Elsevier, vol. 122(9), pages 949-956.
    16. Lim, Jae-Young & Jo, Changik, 2009. "The Effect of Patient's Asymmetric Information Problem on Medical Care Utilization with Consideration of a Patient's Ex-ante Health Status," Hitotsubashi Journal of Economics, Hitotsubashi University, vol. 50(2), pages 37-58, December.
    17. Christian Volmar Skovsgaard & Troels Kristensen & Ryan Pulleyblank & Kim Rose Olsen, 2023. "Increasing capitation in mixed remuneration schemes: Effects on service provision and process quality of care," Health Economics, John Wiley & Sons, Ltd., vol. 32(11), pages 2477-2498, November.

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