Bodnar, Olivia, Gravelle, Hugh Stanley Emrys orcid.org/0000-0002-7753-4233, Gutacker, Nils orcid.org/0000-0002-2833-0621 et al. (1 more author) (2021) Financial incentives and prescribing behaviour in primary care. Working Paper. CHE Research Paper . Centre for Health Economics, University of York , York, UK.
Abstract
Many healthcare systems prohibit primary care physicians from dispensing the drugs they prescribe due to concerns that this encourages excessive, ineffective or unnecessarily costly prescribing. Using data from the English National Health Service for 2011 to 2018, we estimate the impact of physician dispensing rights on prescribing behaviour at the extensive margin (comparing practices that dispense and those that do not) and the intensive margin (comparing practices with different proportions of patients to whom they dispense). Our empirical strategy controls for practices selecting into dispensing based on observable (OLS, entropy balancing) and unobservable practice characteristics (2SLS). We show that physician dispensing raises drug costs per patient by 4.2%, which reflects more and more expensive drugs being prescribed, including potentially inappropriate substances such as opioids. Dispensing practices also prescribe smaller packages as reimbursement is partly based on a fixed fee per prescription dispensed. Similar effects are observed at the intensive margin.
Metadata
Item Type: | Monograph |
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Authors/Creators: |
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Keywords: | Physician dispensing,primary care,drug expenditure,physician agency |
Dates: |
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Institution: | The University of York |
Academic Units: | The University of York > Faculty of Social Sciences (York) > Centre for Health Economics (York) The University of York > Faculty of Social Sciences (York) > Centre for Health Economics (York) > CHE Research Papers (York) |
Depositing User: | Pure (York) |
Date Deposited: | 21 Apr 2021 11:10 |
Last Modified: | 16 Oct 2024 11:39 |
Status: | Published |
Publisher: | Centre for Health Economics, University of York |
Series Name: | CHE Research Paper |
Related URLs: | |
Open Archives Initiative ID (OAI ID): | oai:eprints.whiterose.ac.uk:173250 |
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