Physician-induced demand by Irish GPs

Tussing, A. Dale; Wojtowycz, Martha A.

doi:10.1016/0277-9536(86)90213-3

Cited by 31 publications

(14 citation statements)

References 9 publications

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“…First, study designs differed. Whereas most studies used billing data to measure healthcare consumption, a specific survey to assess who, from the patient or the physician, initiated the next medical consultation was organized in four countries: Australia [34], Ireland [35,36], Norway [37] and USA [38][39][40]. In all these studies, patients were interviewed except in Australia, where doctors themselves were surveyed [34].…”

Section: Resultsmentioning

confidence: 99%

“…mainly elasticities (19 studies) or regression coefficients (13 studies). In four studies, results were expressed as probabilities or odds ratio of a follow-up visit [34][35][36][37]. For the analysis of physician volume, a supplier-induced demand can be inferred when the elasticity or the odds ratio is significantly greater than −1.00 or +1.00 respectively.…”

Section: Tablementioning

confidence: 99%

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Association between physician density and health care consumption: A systematic review of the evidence

Léonard¹,

Stordeur²,

Roberfroid³

2009

Health Policy

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Section: Resultsmentioning

confidence: 99%

Section: Tablementioning

confidence: 99%

Association between physician density and health care consumption: A systematic review of the evidence

Léonard¹,

Stordeur²,

Roberfroid³

2009

Health Policy

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“…Nevertheless, the market for GPs is complex. While a higher supply of GPs might theoretically improve competition and bring prices down (Indecon 2003), literature shows that in such a high supply setting GPs may induce demand through repeat visits in order to boost income (Tussing and Wojtowycz, 1986).…”

Section: Forecasting Distributionmentioning

confidence: 99%

Projecting the Impact of Demographic Change on the Demand for and Delivery of Health Care in Ireland

Barry¹,

Bennett²,

Brick³

et al. 2009

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ISBN 978 0 7070 0289 7 ACKNOWLEDGEMENTSFinancial support for this report and two others in the series was provided by the Health Research Board and the Health Service Executive. The authors would like to thank Maura Hiney from the Health Research Board and the members of the Steering Committee for their support, input and encouragement over the life of the project. Valuable comments on the text and helpful suggestions for revision were made by five anonymous external reviewers. We would like to thank these reviewers for their contributions whilst accepting that the authors bear sole responsibility for the analyses and interpretations presented.

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“…In particular, micro studies used individual-based data that could identify whether utilization was doctor-initiated. [6][7][8][9] This approach overcame many of the 'identification problems' encountered by earlier studies. Several studies tested the hypothesis that GP consultations occurring in areas of high competition were more likely to be follow-up visits (i.e.…”

Section: Introductionmentioning

confidence: 97%

“…utilization initiated by the physician that generates income), ceteris paribus. 6,7,9 Two studies found a positive association between GP density and follow-up 6,7 and one found no evidence of inducement. 9 Although these three 'micro' studies represented an improvement over previous 'macro' studies, they still suffered from several drawbacks which could invalidate their results.…”

Section: Introductionmentioning

confidence: 98%

Analysing the effect of competition on General Practitioners' behaviour using a multilevel modelling framework

Scott

Shiell

1997

Health Econ.

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This paper examines the effect of competition on the behaviour of Australian general practitioners. The paper represents a considerable improvement on the methods of previous studies by using a random effects probit model in a multilevel modelling framework to obtain a more robust estimate of the effect of GP density, by including data on GP and practice characteristics and by using data with the actual GP consultation as the unit of observation which are disaggregated by medical condition. This latter characteristic enables us to test the hypothesis that the effect of competition varies across medical conditions. The main hypothesis tested is that GPs in areas of high competition are more likely to recommend a follow-up consultation compared to GPs in areas of low competition. The results suggest that the density of GPs influences the decision to follow up for one out of the four medical conditions analysed. However, there are other issues to be resolved before such results can be confidently interpreted as evidence of the effect of competition and as evidence of supplier-induced demand.

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Physician-induced demand by Irish GPs

Cited by 31 publications

References 9 publications

Association between physician density and health care consumption: A systematic review of the evidence

Association between physician density and health care consumption: A systematic review of the evidence

Projecting the Impact of Demographic Change on the Demand for and Delivery of Health Care in Ireland

Analysing the effect of competition on General Practitioners' behaviour using a multilevel modelling framework

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