Choice in the presence of experts: The role of general practitioners in patients' hospital choice
Choice in the presence of experts: The role of general practitioners in patients' hospital choice
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DOI：
10.1016/j.jhealeco.2018.06.003
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发表时间：
2018-07-01
影响因子：
3.5
通讯作者：
Beckert, Walter
中科院分区：
文献类型：
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作者：
Beckert, Walter
本文考虑了微观计量经济学分析，病人的医院选择时，他们的选择集是预先选定的全科医生（GP）的选择医疗程序。全科医生在英国国民保健制度的选择性转诊方面发挥双重作用，既要为病人提供咨询，同时还要考虑转诊决定对当地卫生预算的财政影响。本文提出了一个两阶段的选择模型，包括患者和GP水平的优化。它表明，不考虑选择集的战略预选估计可能是有偏的和不一致的。我们发现，全科医生作为病人的代理人选择的选择方案的基础上的质量，但作为代理人的卫生当局也考虑转诊的财政影响。在考虑这些选择时，患者关注的是有形的医院属性，如设施。(C)2018 Elsevier B.V.版权所有。
This paper considers the micro-econometric analysis of patients' hospital choice for elective medical procedures when their choice set is pre-selected by a general practitioner (GP). GPs have a dual role with regard to elective referrals in the English NHS, advising patients and at the same time taking account of the financial implications of referral decisions on local health budgets. The paper proposes a two-stage choice model that encompasses both patient and GP level optimization. It demonstrates that estimators that do not take account of strategic pre-selection of choice sets may be biased and inconsistent. We find that GPs as patients' agents select choice options based on quality, but as agents of health authorities also consider financial implications of referrals. When considering these choice options, patients focus on tangible hospital attributes, like amenities. (C) 2018 Elsevier B.V. All rights reserved.