The Impact of Financial Incentives on Demand and Supply of Health Care Services in Norway: Empirical Studies on Co-Payments and Activity-Based Hospital Financing
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AbstractFinancial incentives in the health care sector are one important tool that has been employed to achieve objectives such as better access to- and efficient use of resources. However, in order to effectively use financial incentives, there is a need for knowledge about the extent to which users and providers respond to the incentives. The aim of this thesis is to contribute to the evidence base on the impact of financial incentives by examining responses to price changes in the Norwegian health care system. Using aggregated registry data for health care services, the studies estimate: i) the effect of price changes in co-payments for adolescents on their use of general practitioner services, and ii) the effect of price changes within activity-based financing for hospitals on their activity levels. Overall, the findings in this thesis support the existing empirical evidence that financial incentives do affect behaviour. The results show that exempting adolescents from co-payments led to adolescents’ increased use of general practitioner services. The findings also indicated that hospitals supply more of the health services for which they receive higher payment. However, the increase in the price for day surgery did not stimulate the provision of day surgeries compared to inpatient surgeries. The findings from this thesis are relevant for both policy-makers and researchers who are interested in the further development and refinement of both demand-side and supply-side incentives to achieve health policy objectives such as improved access to- and efficient delivery of health care services.
List of papers
|Paper I: Did Adolescents in Norway Respond to the Elimination of Co-payments for General Practitioner Services? Olsen CB, Melberg HO. Health Economics. 2018. 7(27):1120–1130. DOI:10.1002/hec.3660. The paper is not available in DUO due to publisher restrictions. The published version is available at: https://doi.org/10.1002/hec.3660|
|Paper II: Did Hospitals Respond to Changes in Weights of Diagnosis Related Groups in Norway between 2006 and 2013? Melberg HO, Olsen CB, Pedersen K. Health Policy. 2016. 120(9):992–1000. DOI:10.1016/j.healthpol.2016.07.013. The article is included in the thesis. Also available at https://doi.org/10.1016/j.healthpol.2016.07.013|
|Paper III: Hospitals’ Response to Changes in Reimbursement for Day Surgery: Evidence from Norway. Olsen CB, Melberg HO, Røgeberg O (Submitted). To be published. The paper is not available in DUO awaiting publishing.|