Competition, Gatekeeping, and Health Care Access
HERO WP 2012/02: Authors: Godager, G. and Iversen, T. Institute of Health and Society and HERO at UiO, and Ma, C. A. Department of Economics, Boston Universtity and University of Oslo.
We study the impact of competition on primary care physicians specialty referrals. Our data come from a Norwegian survey in 2008-9 and Statistics Norway. From the data we construct three measures of competition the number of open primary physician practices with and without population adjustment, and the Herndahl-Hirschman Index. We build a theoretical model, and derive two opposing e¤ects of competition on gatekeeping physicians specialty referrals. The empirical results suggest that competition has negligible or small positive e¤ects on referrals. Our results do not support the policy claim that increasing the number of primary care physicians reduces secondary care.