title: GPs' implicit prioritization through clinical choices - evidence from three national health services.
abstract: We present results from an extensive discrete choice experiment, which was conducted in three countries (Norway, Scotland, and England) with the aim of disclosing stated prescription behaviour in different decision making contexts and across different cost containment cultures. We show that GPs in all countries respond to information about societal costs, benefits and effectiveness, and that they make trade-offs between them. The UK GPs have higher willingness to accept costs when they can prescribe medicines that are cheaper or more preferred by the patient, while Norwegian GPs tend to have higher willingness to accept costs for attributes regarding effectiveness or the doctors' experience. In general, there is a substantial amount of heterogeneity also within each country. We discuss the results from the DCE in the light of the GPs' two conflicting agency roles and what we know about the incentive structures and cultures in the different countries.
authors.affiliation: Department of Economics, University of Bergen, Postbox 7800, 5020 Beregen, Norway. Electronic address: julie.riise@econ.uib.no.
authors.forename: Julie
authors.initials: J
authors.lastname: Riise
authors.affiliation: Department of Economics, The University of Sheffield, 9 Mappin Street, Sheffield S1 4DT, UK.
authors.forename: Arne Risa
authors.initials: AR
authors.lastname: Hole
authors.affiliation: COHERE, Department of Business and Economics, University of Southern Denmark; COHERE, Department of Public Health, University of Southern Denmark; Department of Community Medicine, UiT, The Arctic University of Norway.
authors.forename: Dorte
authors.initials: D
authors.lastname: Gyrd-Hansen
authors.affiliation: Health Economics Research Unit, University of Aberdeen, Polwarth Building, Foresterhill, Aberdeen AB25 2ZD, UK.
authors.forename: Diane
authors.initials: D
authors.lastname: Skåtun
mesh_terms: D002755:Choice Behavior; D004739:England; D006801:Humans; D009313:National Health Programs; D009664:Norway; D010818:Practice Patterns, Physicians'; D055553:Prescription Drugs; D012606:Scotland
chemical_list: D055553:Prescription Drugs
keywords: Cost containment; Discrete choice experiments; GPs; Prescription behaviour; Prioritization