Physician's Production of Primary Care in Ontario, Canada

Authors

Sisira Sarma, The University of Western Ontario
Rose Anne Devlin, University of Ottawa
William Hogg, University of Ottawa

Document Type

Article

Publication Date

1-2010

Journal

Health Economics

Volume

19

Issue

1

First Page

14

Last Page

30

URL with Digital Object Identifier

http://dx.doi.org/10.1002/hec.1447

Abstract

This paper examines the factors affecting the number of patient visits per week reported by family physicians in Ontario. The way that a physician is paid is potentially endogenous to the number of patients seen per week, thus an instrumental variable method of estimation is employed to account for the endogeneity bias. Once account is taken of the endogeneity of remuneration as well as relevant physician and practice characteristics, the estimated elasticity of output with respect to hours worked is 0.74; 0.68 in group practices and 0.82 in solo practices. Physicians paid on a non-fee-for-service (NFFS) conduct 15–31% fewer patient visits per week in comparison to those paid under an FFS scheme. Certain patient populations in practices affect patient visits in important ways, as do a number of physician and practice characteristics.