Evaluation studies on gatekeeping in primary care exist for a variety of countries but provide mixed evidence on utilization and quality of care as well as costs. Our study evaluates the German gatekeeping program, based on claims data of a major statutory health insurance company. The panel structure of the data allows controlling for patients’ characteristics in the year before opting (or not opting) for a GP contract. In contrast to previous studies we are able to draw on multiple identification strategies. We exploit variation in the regional provision of gatekeeping in an instrumental variable (IV) framework. We also analyze GP fixed effects based on the observation of patients opting for one of two different contracts within the same GP office. We find that the gatekeeping contract yields a somewhat higher coordination of care, improved quality (regarding prevention and avoidance of hospitalization) but also higher ambulatory costs. The effects are largely robust between our identification strategies.
On the 18th and 19th of November 2016, the VII. Workshop “Allocation and Distribution” in the Health Care Sector takes place at the University Duisburg-Essen. This will be organized by the committee “Allocation and Distribution” of the German Society for Health Economics together with CINCH and the University Duisburg-Essen. A link to the workshop page can be found here.
In recent years, the City of Essen has evolved into an important location for academic research in health economics. The rise of health economics in Essen is mainly due to a very successful cooperation between the Rheinisch-Westfälisches Institut für Wirtschaftsforschung (RWI) and the Faculty of Business Administration and Economics at the University of Duisburg-Essen. Thanks to extensive international research networks; collaborations with representatives of the health care sector; and a number of successes in the acquisition of competitive research grants, a strong and dynamic research environment has evolved.
The Essen Health Symposium on 24 October 2016 has two specific reasons. First, CINCH, our national research centre for health economic research, has just been awarded a second four-year period of funding. Second, the Leibniz Association has granted Essen a Leibniz Science Campus devoted to health economics. Both programmes are joint ventures between the university of Duisburg-Essen and the RWI. Within CINCH, the Düsseldorf Institute for Competition Economics (DICE) participates as an additional collaborating partner.
CINCH was selected by the Federal Ministry of Education and Research as one out of four national centres for health economic research. Its research focuses on empirical and experimental studies of competition in the health care sector. Our Leibniz Science Campus is devoted to the health care challenges arising in ageing and declining regions. The symposium gathers several distinguished health economists in Essen and aims at making our research known to a broader audience. The keynote address on the topic of competition in the health care sector is given by Carol Propper (Imperial College), upon which two panel discussions follow on the topics “health care challenges in declining regions” and “experimental health economics”.