Jove
Visualize
Contact Us
JoVE
x logofacebook logolinkedin logoyoutube logo
ABOUT JoVE
OverviewLeadershipBlogJoVE Help Center
AUTHORS
Publishing ProcessEditorial BoardScope & PoliciesPeer ReviewFAQSubmit
LIBRARIANS
TestimonialsSubscriptionsAccessResourcesLibrary Advisory BoardFAQ
RESEARCH
JoVE JournalMethods CollectionsJoVE Encyclopedia of ExperimentsArchive
EDUCATION
JoVE CoreJoVE BusinessJoVE Science EducationJoVE Lab ManualFaculty Resource CenterFaculty Site
Terms & Conditions of Use
Privacy Policy
Policies

Related Experiment Videos

Gatekeeping in health care.

Kurt R Brekke1, Robert Nuscheler, Odd Rune Straume

  • 1Department of Economics, Health Economics Bergen (HEB), University of Bergen, Herman Fossgate 6, N-5007 Bergen, Norway. kurt.brekke@nhh.no

Journal of Health Economics
|August 8, 2006
PubMed
Summary

Compulsory gatekeeping in healthcare can intensify hospital competition and specialization due to general practitioners' (GPs) informational role. However, improved diagnostic accuracy by GPs can mitigate these effects, influencing healthcare market dynamics.

Related Concept Videos

You might also read

Related Articles

Articles linked to this work by shared authors, journal, and citation graph.

Sort by
Same author

Competition matters: Uniform vs. indication-based pricing of pharmaceuticals.

Journal of health economics·2026
Same author

Taking the competitor's pill: When combination therapies enter pharmaceutical markets.

Journal of health economics·2025
Same author

Hospital competition when patients learn through experience.

Journal of health economics·2024
Same author

Competition, quality and integrated health care.

Journal of health economics·2024
Same author

The price of cost-effectiveness thresholds under therapeutic competition in pharmaceutical markets.

Journal of health economics·2023
Same author

Paying for pharmaceuticals: uniform pricing versus two-part tariffs.

Journal of health economics·2022

Area of Science:

  • Health Economics
  • Market Competition
  • Healthcare Policy

Background:

  • Direct access to secondary care is often restricted by gatekeeping mechanisms.
  • General practitioners (GPs) play a crucial role in providing information to patients about healthcare options.
  • The secondary care market involves competition between hospitals on quality and specialization.

Purpose of the Study:

  • To analyze the competitive effects of gatekeeping in secondary care.
  • To investigate the influence of general practitioners' (GPs) informational role on hospital competition.
  • To evaluate the impact of diagnostic accuracy and hospital specialization on market outcomes.

Main Methods:

  • Economic modeling of a healthcare market with two competing hospitals.

Related Experiment Videos

  • Analysis of patient decision-making processes involving general practitioners (GPs) for information acquisition.
  • Comparative statics to assess the effects of varying GP attendance and diagnostic accuracy.

    • Main Results:

    • Increased GP attendance amplifies hospital competition and specialization.
    • Improved diagnostic accuracy by GPs dampens hospital competition.
    • Compulsory gatekeeping can lead to excessive quality competition and over-specialization.

    Conclusions:

    • Gatekeeping's impact on market competition is contingent on GP diagnostic accuracy and patient mismatch costs.
    • Second-best price regulation can reduce the need for direct GP consultation regulation.
    • Policy interventions must carefully balance gatekeeping effects to avoid unintended consequences on healthcare quality and specialization.