Physician ownership of complementary medical services

• 成果类型: Article
• 署名作者: Chen, Brian K.; Gertler, Paul J.; Yang, Chun-Yuh
• 署名单位: University of California System; University of California Berkeley; University of South Carolina System; University of South Carolina Columbia; Kaohsiung Medical University
• 刊物名称: JOURNAL OF PUBLIC ECONOMICS
• ISSN/ISSBN: 0047-2727
• DOI: 10.1016/j.jpubeco.2016.09.005
• 发表日期: 2016
• 页码: 27-39
• 关键词: PHYSICIANS; moral hazard; credence goods; Self-referral

摘要

When physicians own complementary medical service facilities such as laboratories and imaging centers, they gain financially by referring patients to these entities. This creates an incentive for the physician to exploit patients' trust by recommending more services than necessary. Using data from Taiwan, which introduced a separating policy, that restricts physician ownership of pharmacies, we estimate that where the policy was binding, eliminating this incentive caused physicians to prescribe 7.1% less in drugs. Taking into account increases in complementary diagnostic services and that drugs are only a part of overall primary care spending, the policy reduced total expenditures by 1.8%. However, a large number of clinics exploited a loophole in the law and either had at baseline or integrated pharmacies into their practices post-policy making them exempt from the policy. As a result, the policy only reduced total drug expenditures by 2.1% and total primary care cost by 0.5%. (C) 2016 Elsevier B.V. All rights reserved.