Danish Centre for Health Economics, Department of Public Health, University of Southern Denmark, J.B. Winsløws Vej 9B, 5000, Odense, Denmark.
Research Unit for General Practice, University of Southern Denmark, J.B. Winsløws Vej 9A, 5000, Odense, Denmark.
Eur J Health Econ. 2021 Aug;22(6):977-989. doi: 10.1007/s10198-021-01302-3. Epub 2021 Apr 11.
In many health care systems GPs receive fees for their services. Policymakers may use the size of these fees to try to incentivise GPs to provide more care. However, evidence is mixed on whether and how GPs respond to an increase in the fee size. This study investigates how GPs respond to an average increase of 150% in the fee for a high-effort and infrequent service such as a home visit due to patients' illness. We consider Danish GPs' provision of these visits to enlisted patients living outside of nursing homes. Using linear regressions with general practice fixed effects and a rich number of control variables, we estimate the association between GPs' provision of these home visits and the fee rise. On average, we find no association between the fee rise and GPs' provision of home visits. However, we find that GPs who previously provided the fewest home visits to eligible patients increase their provision by 13% after the fee rise compared to other GPs. This increase in visits is driven by more patients receiving multiple visits after the fee rise. We conclude that a fee rise may not yield a strong response in GPs' provision of high-effort and infrequent services such as home visits.
在许多医疗保健系统中,全科医生的服务会收取费用。政策制定者可能会利用这些费用的大小来激励全科医生提供更多的医疗服务。然而,关于全科医生是否以及如何对费用的增加做出反应,证据不一。本研究调查了全科医生对由于患者病情而导致的高努力和不频繁服务(如家访)的费用平均增加 150%的反应。我们考虑了丹麦全科医生为居住在养老院之外的在册患者提供这些访问的情况。我们使用具有一般实践固定效应和大量控制变量的线性回归来估计全科医生提供这些家访的次数与费用增加之间的关联。平均而言,我们发现费用增加与全科医生提供家访之间没有关联。然而,我们发现,与其他全科医生相比,之前为符合条件的患者提供家访次数最少的全科医生在费用增加后将家访次数增加了 13%。家访次数的增加是由于费用增加后更多的患者接受了多次家访。我们的结论是,费用的增加可能不会导致全科医生在提供高努力和不频繁的服务(如家访)方面做出强烈反应。