Scandinavian Working Papers in Economics

HERO Online Working Paper Series,
University of Oslo, Health Economics Research Programme

No 2020:4: Technology Adoption in Primary Health Care

Tor Iversen () and Albert Ma Ching-to
Additional contact information
Tor Iversen: Department of Health Management and Health Economics, University of Oslo, Postal: HERO / Department of Health Management and Health Economics, P.O. Box 1089 Blindern, NO-0317 Oslo, Norway
Albert Ma Ching-to: Department of Economics, Boston University

Abstract: We study primary care physicians’ prevention and monitoring technology adoption. Physicians are assumed to decide to adopt based on benefits and costs, which depend on payment incentives, educational assistance, and market characteristics. The empirical study uses national Norwegian register and physician claims data between 2009 and 2014. In 2006, a new annual comprehensive checkup for Type 2 diabetic patients was introduced. A physician collects a fee for each checkup. In 2013, an education assistance program was introduced in two Norwegian counties. We estimate adoption decisions by two-part and fixed-effect regressions, and hazard models. We use a difference-in-difference model to estimate the education program impact. Adoptions are positively associated with a physician’s number of diabetic patients, and the fraction of physician-adopters in the same market. Fixed-effect estimations and separate analyses of physicians who have moved between municipalities causally support a peer effect. The education program has a strongly positive effect.

Keywords: primary care; technology; monitoring; incentives; education program

JEL-codes: I11; I18; O31

36 pages, August 27, 2020

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