{"title":"价格管制的医疗保健市场中的竞争和医生诱导的需求:来自加纳的证据。","authors":"Adolf Kwadzo Dzampe, Shingo Takahashi","doi":"10.1007/s10754-021-09320-7","DOIUrl":null,"url":null,"abstract":"<p><p>Using panel data of administrative claims spanning 36 months (2017-2019) and an instrumental variable method, this study examines whether physician-induced demand for hypertension disease care exists in Ghana's healthcare system where price is regulated, and there is no co-payment. We find that an increase in competition-measured as a high doctor-to-population ratio at the district level-leads to an increase in the number of physician visits, suggesting physician-induced demand exists, and that effects are greater for large hospitals and public health providers. This result is further supported by alternative measures and specifications showing that physicians' revenue from medication and gross revenue increase as the physician density increases. These pattern suggest that physicians in high density areas, faced with a decrease in number of patients per physician, make up for the decline in income by inducing more patient visits.</p>","PeriodicalId":44403,"journal":{"name":"International Journal of Health Economics and Management","volume":"22 3","pages":"295-313"},"PeriodicalIF":1.5000,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9365740/pdf/","citationCount":"8","resultStr":"{\"title\":\"Competition and physician-induced demand in a healthcare market with regulated price: evidence from Ghana.\",\"authors\":\"Adolf Kwadzo Dzampe, Shingo Takahashi\",\"doi\":\"10.1007/s10754-021-09320-7\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p>Using panel data of administrative claims spanning 36 months (2017-2019) and an instrumental variable method, this study examines whether physician-induced demand for hypertension disease care exists in Ghana's healthcare system where price is regulated, and there is no co-payment. We find that an increase in competition-measured as a high doctor-to-population ratio at the district level-leads to an increase in the number of physician visits, suggesting physician-induced demand exists, and that effects are greater for large hospitals and public health providers. This result is further supported by alternative measures and specifications showing that physicians' revenue from medication and gross revenue increase as the physician density increases. These pattern suggest that physicians in high density areas, faced with a decrease in number of patients per physician, make up for the decline in income by inducing more patient visits.</p>\",\"PeriodicalId\":44403,\"journal\":{\"name\":\"International Journal of Health Economics and Management\",\"volume\":\"22 3\",\"pages\":\"295-313\"},\"PeriodicalIF\":1.5000,\"publicationDate\":\"2022-09-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9365740/pdf/\",\"citationCount\":\"8\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"International Journal of Health Economics and Management\",\"FirstCategoryId\":\"96\",\"ListUrlMain\":\"https://doi.org/10.1007/s10754-021-09320-7\",\"RegionNum\":4,\"RegionCategory\":\"经济学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"BUSINESS, FINANCE\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"International Journal of Health Economics and Management","FirstCategoryId":"96","ListUrlMain":"https://doi.org/10.1007/s10754-021-09320-7","RegionNum":4,"RegionCategory":"经济学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"BUSINESS, FINANCE","Score":null,"Total":0}
Competition and physician-induced demand in a healthcare market with regulated price: evidence from Ghana.
Using panel data of administrative claims spanning 36 months (2017-2019) and an instrumental variable method, this study examines whether physician-induced demand for hypertension disease care exists in Ghana's healthcare system where price is regulated, and there is no co-payment. We find that an increase in competition-measured as a high doctor-to-population ratio at the district level-leads to an increase in the number of physician visits, suggesting physician-induced demand exists, and that effects are greater for large hospitals and public health providers. This result is further supported by alternative measures and specifications showing that physicians' revenue from medication and gross revenue increase as the physician density increases. These pattern suggest that physicians in high density areas, faced with a decrease in number of patients per physician, make up for the decline in income by inducing more patient visits.
期刊介绍：
The focus of the International Journal of Health Economics and Management is on health care systems and on the behavior of consumers, patients, and providers of such services. The links among management, public policy, payment, and performance are core topics of the relaunched journal. The demand for health care and its cost remain central concerns. Even as medical innovation allows providers to improve the lives of their patients, questions remain about how to efficiently deliver health care services, how to pay for it, and who should pay for it. These are central questions facing innovators, providers, and payers in the public and private sectors. One key to answering these questions is to understand how people choose among alternative arrangements, either in markets or through the political process. The choices made by healthcare managers concerning the organization and production of that care are also crucial. There is an important connection between the management of a health care system and its economic performance. The primary audience for this journal will be health economists and researchers in health management, along with the larger group of health services researchers. In addition, research and policy analysis reported in the journal should be of interest to health care providers, managers and policymakers, who need to know about the pressures facing insurers and governments, with consequences for regulation and mandates. The editors of the journal encourage submissions that analyze the behavior and interaction of the actors in health care, viz. consumers, providers, insurers, and governments. Preference will be given to contributions that combine theoretical with empirical work, evaluate conflicting findings, present new information, or compare experiences between countries and jurisdictions. In addition to conventional research articles, the journal will include specific subsections for shorter concise research findings and cont ributions to management and policy that provide important descriptive data or arguments about what policies follow from research findings. The composition of the editorial board is designed to cover the range of interest among economics and management researchers.Officially cited as: Int J Health Econ ManagFrom 2001 to 2014 the journal was published as International Journal of Health Care Finance and Economics. (Articles published in Vol. 1-14 officially cited as: Int J Health Care Finance Econ)
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