Helse Sør-Øst Health Services Research Centre, Akershus University Hospital, Norway.
J Health Econ. 2010 Sep;29(5):751-64. doi: 10.1016/j.jhealeco.2010.07.004. Epub 2010 Jul 17.
Income motivation among general practitioners (GPs) is frequently discussed in the health economics literature. The question addressed in the present study on reimbursement drugs and addictive drugs is whether increased competition among GPs, which is part of a declared health policy to improve efficiency, contributes to more prescriptions for the elderly. The dataset comprises registered data of all prescribed drugs dispensed at pharmacies from the Norwegian Prescription Database merged with data on GPs. In choosing a method, particular attention is given to the fact that patients tend to be attracted to GPs who fit their preferences. Hence, we treat the composition of the patient list as endogenous. The results indicate that the stronger competition a GP faces, the more drugs are prescribed, which implies that GPs' prescription style may conflict with their role as gatekeepers, and even worse, it may be a hazard to patients' health.
在卫生经济学文献中，经常讨论全科医生（GP）的收入动机。本研究探讨了报销药物和成瘾药物的问题，即 GP 之间竞争的加剧是否有助于为老年人开出更多的处方，这是提高效率的既定卫生政策的一部分。该数据集包含了从挪威处方数据库中合并的所有在药店配药的处方药物的注册数据，以及关于 GP 的数据。在选择方法时，特别注意到这样一个事实，即患者往往倾向于选择符合他们偏好的 GP。因此，我们将患者名单的构成视为内生的。结果表明，GP 面临的竞争越激烈，开出的药物就越多，这意味着 GP 的处方风格可能与其作为守门人的角色相冲突，甚至更糟糕的是，这可能对患者的健康造成危害。
