Choice in the presence of experts: the role of general practitioners in patients’ hospital choice

Document type
Beckert, Walter; Collyer, Kate
Institute for Fiscal Studies
Date of publication
14 November 2016
IFS Working Paper; W16/21
Health Services
Social welfare
Material type

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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). It proposes a two-stage choice model that encompasses both, patient and GP level optimization, and it discusses identification.

The empirical analysis demonstrates biases and inconsistencies that arise when strategic pre-selection is not properly taken into account. It also suggests that patients defer to GPs when assessing hospital quality and focus on tangible attributes, like hospital amenities. GPs, in turn present choice options based on quality, but as agents of health authorities also consider their financial implications.

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