Template-Type: ReDIF-Paper 1.0

Author-Name: Claudio Lucifora
Author-X-Name-First: Claudio
Author-X-Name-Last: Lucifora
Author-Email: claudio.lucifora@unicatt.it
Author-Workplace-Name: Università Cattolica del Sacro Cuore
Author-Workplace-Name: Dipartimento di Economia e Finanza, Università Cattolica del Sacro Cuore

Author-Name: Antonio Russo
Author-X-Name-First: Antonio
Author-X-Name-Last: Russo


Author-Name: Daria Vigani
Author-X-Name-First: Daria
Author-X-Name-Last: Vigani
Author-Workplace-Name: Università Cattolica del Sacro Cuore
Author-Workplace-Name: Dipartimento di Economia e Finanza, Università Cattolica del Sacro Cuore



Title: Does prescribing appropriateness reduce health expenditures? Main effects and unintended outcomes.


Abstract: We evaluate the effectiveness of a reform to contain health-care costs by restraining general
practitioners' (GP) ability to prescribe outpatient treatments, on the basis of strict appropriateness
criteria. Using register data for a large Metropolitan area in Italy, we find a significant
contraction in both outpatient expenditures (-24%) and volumes (-12%) after the reform. The
effects on expenditures are found to be heterogeneous across GPs' characteristics, pointing out
the mediating role of GPs' prescribing behavior. The reform also affected the composition of
outpatient spending and produced unintended consequences on the demand for medical services
of vulnerable groups, who were originally excluded from its application, as well as on access to
emergency care. 
Length: 30
Creation-Date: 2021-05
File-URL: http://dipartimenti.unicatt.it/economia-finanza-def103.pdf
File-Format: Application/pdf
File-Function: First version, 2021
Number: def103
Classification-JEL: H51 I38 I18. 
Keywords: Prescribing appropriateness, Health-care expenditures, Primary care.
Handle: RePEc:ctc:serie1:def103