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Competition between General Practitioners and Specialists in the Primary Health Care Market

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  • Brasseur, Carine

    (UNIVERSITE CATHOLIQUE DE LOUVAIN, Institut de Recherches Economiques et Sociales (IRES) ; Belgian National Fund for Scientific Research (FNRS))

Abstract

In this paper, we study the optimal payment system for the primary health care market when general practitioners are not only in competition between themselves but also with specialists. We define the copayment to impose in order to ensure a good allocation of patients among the two types of physicians. Further, we set the physician reimbursement system that guarantees an appropriate referral of patients to specialists. We prove that the GP's remuneration system is more prospective the larger the competition with specialists. Next, we show that the assumption of risk-averse patients precludes the optimal payment system from being a first-best solution. To conclude, we contrast the results of the analysis with systems of gatekeepers where all patients are required to go to a general practitioner before having access to specialized medicine.

Suggested Citation

  • Brasseur, Carine, 2001. "Competition between General Practitioners and Specialists in the Primary Health Care Market," LIDAM Discussion Papers IRES 2001004, Université catholique de Louvain, Institut de Recherches Economiques et Sociales (IRES).
    • Handle: RePEc:ctl:louvir:2001004
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    File URL: http://sites.uclouvain.be/econ/DP/IRES/2001-4.pdf
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    References listed on IDEAS

    as
    1. Asher Wolinsky, 1993. "Competition in a Market for Informed Experts' Services," RAND Journal of Economics, The RAND Corporation, vol. 24(3), pages 380-398, Autumn.
    2. Begoña García Mariñoso & Izabela Jelovac, 2000. "GPs’ Payment Contracts and their Referral Policy," Documentos de trabajo - Analise Economica 0010, IDEGA - Instituto Universitario de Estudios e Desenvolvemento de Galicia.
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    More about this item

    Keywords

    health care; competition; gatekeeping; payment system;
    All these keywords.

    JEL classification:

    • I10 - Health, Education, and Welfare - - Health - - - General
    • D60 - Microeconomics - - Welfare Economics - - - General

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