Beyond the Clock:Exploring the Causal Relationship between General Practitioner Time Allocation and Hospital Referrals

This paper presents an analysis of an experiment conducted in the Netherlands to evaluate the impact of a new way of working for General Practitioners (GPs) with respect to hospital referrals and healthcare spending. The new way of working gave GPs more time to spend on each patient, and we employed a Bayesian difference-in-differences approach to estimate the effect of this intervention. To assess the impact of the new way of working, we created a control group consisting of regional GP practices that did not implement the new approach and analyzed data on hospital referrals and healthcare spending in both the practice that implemented the new approach (the treatment practice) and the control group, both before and after the intervention. Our analysis shows that the new approach led to a substantial reduction in the total number of hospital referrals. We also observed a decrease in overall healthcare spending on combined GP and hospital care for the treatment practice relative to the control group

Hospital Competition in the Netherlands:An Empirical Investigation

The Dutch government introduced managed competition to the health care sec- tor in 2006. In this regulatory framework insurers compete for enrollees and providers compete for contracts with insurers. The resulting contracts are de- termined by bargaining, which outcome depends on the relative position of the provider. In this paper, we compare how commonly used market power indi- cators predict bargaining outcomes. We combine 2013 transaction data with bilateral contract data. Our empirical models explain the relative dierences in hospitals' revenues while controlling for dierences in the complexity of patients. Four indicators are used: the logit competition index (LOCI), willingness-to-pay (WTP), Elzinga-Hogarty market share and a rule-of-thumb market share. We nd that WTP and LOCI perform best empirically