Competition and physician behaviour: Does the competitive environment affect the propensity to issue sickness certificates?

B-Tier
Journal: Journal of Health Economics
Year: 2019
Volume: 66
Issue: C
Pages: 117-135

Authors (4)

Brekke, Kurt R. (Norges Handelshøyskole (NHH)) Holmås, Tor Helge (not in RePEc) Monstad, Karin (not in RePEc) Straume, Odd Rune (Universidade do Minho)

Score contribution per author:

0.503 = (α=2.01 / 4 authors) × 1.0x B-tier

α: calibrated so average coauthorship-adjusted count equals average raw count

Abstract

Competition among physicians is widespread, but compelling empirical evidence on its impact on service provision is limited, mainly due to endogeneity issues. In this paper we exploit that many GPs, in addition to own practice, work in local emergency centres, where the matching of patients to GPs is random. The same GP is observed both with competition (own practice) and without (emergency centre). Using high-dimensional fixed-effect models, we find that GPs with a fee-for-service (fixed-salary) contract are 12 (8) percentage points more likely to certify sick leave at own practice than at the emergency centre. Thus, competition has a positive impact on GPs’ sicklisting that is strongly reinforced by financial incentives.

Technical Details

RePEc Handle
repec:eee:jhecon:v:66:y:2019:i:c:p:117-135
Journal Field
Health
Author Count
4
Added to Database
2026-01-24