Please use this identifier to cite or link to this item: https://hdl.handle.net/10419/173955 
Year of Publication: 
2016
Series/Report no.: 
IFS Working Papers No. W16/21
Publisher: 
Institute for Fiscal Studies (IFS), London
Abstract: 
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 identifi cation. The empirical analysis demonstrates biases and inconsistencies that arise when strategic pre-selection is not properly taken into account. We fi nd that patients defer to GPs when assessing hospital quality and focus on tangible attributes, like hospital amenities; and that GPs, in turn, as patients' agents present choice options based on quality, but as agents of health authorities also consider their financial implications.
Subjects: 
discrete choice
patient
principal
GP
agent
expert
endogenous choice sets
competition
hospital choice
elective medical procedure
JEL: 
D12
C51
I11
G11
Persistent Identifier of the first edition: 
Document Type: 
Working Paper

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