Do doctors charge high income patients more?

Johar, Meliyanni

doi:10.1016/j.econlet.2012.07.024

Cited by 18 publications

(27 citation statements)

References 14 publications

(9 reference statements)

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“…This finding matches the prediction from our theoretical model that the average taste for quality in a market ( ), which we proxy with socio-economic status, increases the responsiveness of price to competition. The finding is also in line with Johar (2012) who finds the relationship between patient income and prices charged is larger in areas with higher GP density.…”

Section: Discussionsupporting

confidence: 80%

“…Instead, most physician market studies have used physician density (physicians per capita in an area) (Bradford and Martin, 2000;Johar, 2012;Richardson et al, 2006;Savage and Jones, 2004). This approach has the disadvantage that all physicians in an area are assumed to face the same competitive pressure.…”

Section: Pricesmentioning

confidence: 99%

“…Savage and Jones (2004) ing GP supply with area characteristics, an increase in area GP supply is found to be associated with higher prices. In a recent study, Johar (2012) uses patient-level data to examine the relationship between prices and patient income. She finds that in areas with more GPs the effect of patient income on price is reduced.…”

Section: Related Literaturementioning

confidence: 99%

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Competition, Prices and Quality in the Market for Physician Consultations

et al. 2013

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Prices for consultations with General Practitioners (GPs) in Australia are unregulated, and patients pay the difference between the price set by the GP and a fixed reimbursement from the national tax-funded Medicare insurance scheme. We construct a Vickrey-Salop model of GP price and quality competition and test its predictions using individual GP-level data on prices, the proportion of patients who are charged no out-of-pocket fee, average consultation length, and characteristics of the GPs, their practices and their local areas. We measure the competition to which the GP is exposed by the distance to other GP practices and allow for the endogeneity of GP location decisions with measures of area characteristics and area fixedeffects. Within areas, GPs with more distant competitors charge higher prices and a smaller proportion of their patients make no out-of-pocket payment. GPs with more distant competitors also have shorter consultations, though the effect is small and statistically insignificant. JEL: I11, I13, L1

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Section: Discussionsupporting

confidence: 80%

Section: Pricesmentioning

confidence: 99%

Section: Related Literaturementioning

confidence: 99%

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Competition, Prices and Quality in the Market for Physician Consultations

et al. 2013

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“…A previous study, based entirely on post-Strengthening Medicare reform data, showed that patients' income was a significant driver of the fees charged by Australian GPs (Johar, 2012). A previous study, based entirely on post-Strengthening Medicare reform data, showed that patients' income was a significant driver of the fees charged by Australian GPs (Johar, 2012).…”

Section: Discussionmentioning

confidence: 99%

“…A more recent study, looking at fees charged by GPs in the most populous Australian state, New South Wales, found that doctors charge higher fees to higher income patients compared with those with lower incomes (Johar, 2012). This finding suggests that those with lower incomes face lower OOP costs per visit.…”

Section: Settingmentioning

confidence: 99%

The Rise and Fall in Out-of-Pocket Costs in Australia: An Analysis of theStrengthening MedicareReforms

et al. 2016

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After a period of steady decline, out-of-pocket (OOP) costs for general practitioner (GP) consultations in Australia began increasing in the mid-1990s. Following the rising community concerns about the increasing costs, the Australian Government introduced the Strengthening Medicare reforms in 2004 and 2005, which included a targeted incentive for GPs to charge zero OOP costs for consultations provided to children and concession cardholders (older adults and the poor), as well as an increase in the reimbursement for all GP visits. This paper examines the impact of those reforms using longitudinal survey and administrative data from a large national sample of women. The findings suggest that the reforms were effective in reducing OOP costs by an average of $A0.40 per visit. Decreases in OOP costs, however, were not evenly distributed. Those with higher pre-reform OOP costs had the biggest reductions in OOP costs, as did those with concession cards. However, results also reveal increases in OOP costs for most people without a concession card. The analysis suggests that there has been considerable heterogeneity in GP responses to the reforms, which has led to substantial changes in the fees charged by doctors and, as a result, the OOP costs incurred by different population groups. Copyright © 2016 John Wiley & Sons, Ltd.

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What Explains the Quality and Price of Gp Services? An Investigation Using Linked Survey and Administrative Data

2014

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We examine patient socioeconomic status, the strength of the patient-doctor relationship and local area competition as determinants of the quality and price of GP services. We exploit a large-sample patient data set in Australia and its linkage to administrative databases. The sample contains over 260,000 patients and over 12,600 GPs, observed between 2005 and 2010. Controlling for GP fixed effects and patient health, we find no strong evidence that quality differs by patient age, gender, country of origin, health concession card status and income, but quality is increased by stronger patient-doctor relationship. Using a competition measure that is defined at the individual GP level and not restricted to a local market, we find that competition lowers quality. Price is increasing in patient income, whereas competition has a small impact on price.

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Do doctors charge high income patients more?

Abstract: When doctors are unconstrained in setting fees, they charge higher fees to high income patients. For a standard GP consultation, the average fee gap 25% of a minimum price. Competition closes this gap, but not local area income.

Cited by 18 publications

References 14 publications

Competition, Prices and Quality in the Market for Physician Consultations

Competition, Prices and Quality in the Market for Physician Consultations

The Rise and Fall in Out-of-Pocket Costs in Australia: An Analysis of theStrengthening MedicareReforms

What Explains the Quality and Price of Gp Services? An Investigation Using Linked Survey and Administrative Data

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