The impact of budgets for gatekeeping physicians on patient satisfaction: Evidence from fundholding

M. Dusheiko; H. Gravelle; N. Yu; S. Campbell

doi:10.1016/j.jhealeco.2006.12.003

The impact of budgets for gatekeeping physicians on patient satisfaction: Evidence from fundholding

M. Dusheiko, H. Gravelle, N. Yu, S. Campbell

Centre for Health Economics

Research output: Contribution to journal › Article › peer-review

Abstract

Between 1991 and 1998 English general practices had the option of holding budgets for prescribing and elective secondary care. Fundholding was reintroduced in 2005. We examine the effect of fundholding on patients’ satisfaction with their practice, using a cross section of 4441 patients from 60 practices in the last year of fundholding (1998). We employ instrumental variables to allow for the endogeneity of fundholding. Patients of fundholders were less satisfied with the opening hours of their practice, their GP's knowledge of their medical history, with their GP's ability to arrange tests and willingness to refer to a specialist, and were more likely to agree that their doctor was more concerned about keeping costs down. Fundholder practices performed better on a number of process measures of care, and fundholding patients were more satisfied with additional non-medical services provided by the practice. The probability that patients were overall at least very satisfied with their GP practice was 0.073 (95% CI, 0.009–0.138) smaller in fundholding practices.

Original language	English
Pages (from-to)	742-762
Number of pages	20
Journal	Journal of Health Economics
Volume	26
Issue number	4
DOIs	https://doi.org/10.1016/j.jhealeco.2006.12.003
Publication status	Published - 1 Jul 2007

Access to Document

10.1016/j.jhealeco.2006.12.003

http://dx.doi.org/10.1016/j.jhealeco.2006.12.003

Cite this

@article{007bc4c150d445aca109bbc31532085e,

title = "The impact of budgets for gatekeeping physicians on patient satisfaction: Evidence from fundholding",

abstract = "Between 1991 and 1998 English general practices had the option of holding budgets for prescribing and elective secondary care. Fundholding was reintroduced in 2005. We examine the effect of fundholding on patients{\textquoteright} satisfaction with their practice, using a cross section of 4441 patients from 60 practices in the last year of fundholding (1998). We employ instrumental variables to allow for the endogeneity of fundholding. Patients of fundholders were less satisfied with the opening hours of their practice, their GP's knowledge of their medical history, with their GP's ability to arrange tests and willingness to refer to a specialist, and were more likely to agree that their doctor was more concerned about keeping costs down. Fundholder practices performed better on a number of process measures of care, and fundholding patients were more satisfied with additional non-medical services provided by the practice. The probability that patients were overall at least very satisfied with their GP practice was 0.073 (95% CI, 0.009–0.138) smaller in fundholding practices.",

author = "M. Dusheiko and H. Gravelle and N. Yu and S. Campbell",

year = "2007",

month = jul,

day = "1",

doi = "10.1016/j.jhealeco.2006.12.003",

language = "English",

volume = "26",

pages = "742--762",

journal = "Journal of Health Economics",

publisher = "Elsevier",

number = "4",

}

TY - JOUR

T1 - The impact of budgets for gatekeeping physicians on patient satisfaction: Evidence from fundholding

AU - Dusheiko, M.

AU - Gravelle, H.

AU - Yu, N.

AU - Campbell, S.

PY - 2007/7/1

Y1 - 2007/7/1

N2 - Between 1991 and 1998 English general practices had the option of holding budgets for prescribing and elective secondary care. Fundholding was reintroduced in 2005. We examine the effect of fundholding on patients’ satisfaction with their practice, using a cross section of 4441 patients from 60 practices in the last year of fundholding (1998). We employ instrumental variables to allow for the endogeneity of fundholding. Patients of fundholders were less satisfied with the opening hours of their practice, their GP's knowledge of their medical history, with their GP's ability to arrange tests and willingness to refer to a specialist, and were more likely to agree that their doctor was more concerned about keeping costs down. Fundholder practices performed better on a number of process measures of care, and fundholding patients were more satisfied with additional non-medical services provided by the practice. The probability that patients were overall at least very satisfied with their GP practice was 0.073 (95% CI, 0.009–0.138) smaller in fundholding practices.

AB - Between 1991 and 1998 English general practices had the option of holding budgets for prescribing and elective secondary care. Fundholding was reintroduced in 2005. We examine the effect of fundholding on patients’ satisfaction with their practice, using a cross section of 4441 patients from 60 practices in the last year of fundholding (1998). We employ instrumental variables to allow for the endogeneity of fundholding. Patients of fundholders were less satisfied with the opening hours of their practice, their GP's knowledge of their medical history, with their GP's ability to arrange tests and willingness to refer to a specialist, and were more likely to agree that their doctor was more concerned about keeping costs down. Fundholder practices performed better on a number of process measures of care, and fundholding patients were more satisfied with additional non-medical services provided by the practice. The probability that patients were overall at least very satisfied with their GP practice was 0.073 (95% CI, 0.009–0.138) smaller in fundholding practices.

U2 - 10.1016/j.jhealeco.2006.12.003

DO - 10.1016/j.jhealeco.2006.12.003

M3 - Article

VL - 26

SP - 742

EP - 762

JO - Journal of Health Economics

JF - Journal of Health Economics

IS - 4

ER -