Remunerating general practitioners with fees

Between economic incentives and professional norms

Authors

  • Lotte Bøgh Andersen Department of Political Science and Government, Aarhus University, Denmark
  • Søren Serritzlew Department of Political Science and Government Aarhus University, Denmark

DOI:

https://doi.org/10.58235/sjpa.v15i4.16156

Keywords:

Economic incentives, Professional norms, Supplier-induced demand, General practitioners, Health care

Abstract

In all the Scandinavian countries, general practitioners (GPs) are, to a varying degree, remunerated with fee per service. Fees can be powerful economic incentives. However, whether or not GPs respond to these incentives is a point of contention in the literature. Some studies find strong associations between the number of patients and service utilization per patient, and interpret this as evidence of supplier-induced demand, other studies do not. The central claim here is that it may depend on the professional norms. Specifically, we expect GPs to respond to economic incentives only if professional norms (prescriptions for the acceptable actions within a given occupation) are absent or weak. To test this, we compare ordinary consultations, talk therapy and house calls for Danish GPs. Ordinary consultations are regulated by strong professional norms; house calls are regulated by norms of medium strength; and only very weak norms apply to talk therapy. As expected, we find stronger effects of economic incentives when the professional norms are weak and conclude that both economic incentives and professional norms are important factors.

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Author Biographies

Lotte Bøgh Andersen, Department of Political Science and Government, Aarhus University, Denmark

Lotte Bøgh Andersen is professor at the Department of Political Science and Government at Aarhus University and at the Danish Institute of Governmental Research. Her research interests include motivation, behaviour and performance of public employees, leadership and use of economic incentives in the public sector and the relationship between professionals and service users. E-mail: lotte@ps.au.dk

Søren Serritzlew, Department of Political Science and Government Aarhus University, Denmark

Søren Serritzlew is professor at the Department of Political Science and Government at Aarhus University, Denmark. His research interests include effects of public sector reform, use of economic incentives in the public sector, and democracy. E-mail: soren@ps.au.dk

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Published

2011-12-15

How to Cite

Bøgh Andersen, L., & Serritzlew, S. (2011). Remunerating general practitioners with fees: Between economic incentives and professional norms. Scandinavian Journal of Public Administration, 15(4), 25–44. https://doi.org/10.58235/sjpa.v15i4.16156

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Original Articles

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