Primary physician services—List size and primary physicians’ service production

Abstract

The regular general practitioner scheme was introduced in Norway in 2001. A patient list system in combination with a partial per capita financing system for primary physician services was then introduced. The focus of this research was to study how the patient list system influences patients’ accessibility to primary physicians, and how the system influences primary physicians’ service production. We studied two possibilities: First, some physicians can have an incentive to acquire a long patient list in order to ensure a high unearned income from per capita payment. This can lead to rationing of consultations. Second, physicians with short lists can have an incentive to increase their service production per consultation in order to compensate for lack of income. This leads to increased costs. The research questions were investigated empirically using two large sets of national data. Two of the main findings were that long lists do not lead to rationing, and short lists do not increase service production per consultation.