Can a Public Health Care System Achieve Equity?

Grytten, Jostein; Rongen, Gunnar; Sørensen, Rune J.

doi:10.1097/00005650-199509000-00005

Cited by 19 publications

(12 citation statements)

References 19 publications

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“…Secondly, the population's health status (CHILD06, UNEMPL, SOCIAL and MORTAL) is slightly better in the municipalities with lower number of visits and smaller revenue generated from laboratory tests. This is in accordance with findings from other Norwegian studies [24][25][26][27][28]. An exception is that there are more people aged 68 years and over (OLD68) in municipalities with the fewest visits and the least revenue from laboratory tests.…”

Section: Resultssupporting

confidence: 92%

More physicians: improved availability or induced demand?

Carlsen¹,

Grytten²

1998

Health Econ.

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A number of empirical studies have shown that there is a negative association between population:physician ratio and utilization of medical services. However, it is not clear whether this relationship reflects supplier-inducement, the effect of lower prices on patient demand, a supply response to variation in health status, or improved availability. In Norway, patient fees and state reimbursement fees are set centrally. Therefore, the correlation between utilization and population:physician ratio either reflects supplier-inducement, a supply response or an availability effect. We applied a theoretical model which distinguished between an inducement and an availability effect. The model was implemented on a cross-sectional data set which contained information about patient visits and laboratory tests for all fee-for-service primary care physicians in Norway. Since population:physician ratio is potentially endogenous, an instrumental variable approach is used. We found no evidence for inducement either for number of visits or for provision of laboratory services.

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Section: Resultssupporting

confidence: 92%

More physicians: improved availability or induced demand?

Carlsen¹,

Grytten²

1998

Health Econ.

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“…The number of consultations increases as the proportion of female patients on the list increases. This finding is also consistent with the results from other studies from Norway, where it has been found that women visit the physician more often than men (Grytten et al, 1995a;Paulsen, 1995).…”

Section: Discussionsupporting

confidence: 93%

Primary physician services—List size and primary physicians’ service production

Grytten¹,

Sørensen²

2007

Journal of Health Economics

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“…The evidence is twofold. Firstly, the available evidence indicates that there is no rationing of consultations for primary physician services in Norway [14,15]. National survey data have shown that there is no relationship between physician density and patient-initiated visits [14].…”

Section: Review Of the Literaturementioning

confidence: 99%

“…Variations in patient visits can be explained by (a) differences in health status, (b) differences in health care preferences, and (c) differences in access to a contract physician. In an earlier study of patient behaviour based on the Norwegian Health Surveys from 1975 and 1985 [14], it was found that individual health conditions are the major determinant of physician visits. The probability of visiting a physician is highly influenced by levels of chronic illness and other manifest indicators of health status.…”

Section: Patients' Demand For Physician Ser6icesmentioning

confidence: 99%

Competition and supplier-induced demand in a health care system with fixed fees

Sørensen

Grytten

1999

Health Econ.

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The present paper examines whether supplier-induced demand exists for primary physician services in Norway. The research design is adapted to the institutional setting of Norwegian primary physician services, where there is a fixed fee schedule. More than 50% of primary care physicians receive a payment for treatment from the National Insurance Administration on a fee-for-item basis. The results showed that increased competition, measured as a high physician:population ratio, led to a decline in the number of consultations per contract physician. However, the contract physicians in high physician density areas did not compensate for the lack of patients by providing more items of treatment in order to maintain their income. Contract physicians' revenue from items of treatment per consultation were unaffected both by physician density and by the number of consultations per contract physician. These results are further corroborated by data that showed that contract physicians' gross revenue and profits were declining functions of physician density. This paper argues that, from an efficiency point of view, a deregulated health care market with fixed fees may operate well.

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Can a Public Health Care System Achieve Equity?

Cited by 19 publications

References 19 publications

More physicians: improved availability or induced demand?

More physicians: improved availability or induced demand?

Primary physician services—List size and primary physicians’ service production

Competition and supplier-induced demand in a health care system with fixed fees

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