@Misc{duepublico_mods_00074978,
  author = 	{Avdic, Daniel
		and Blankart, Katharina},
  title = 	{A Hard Look at ``Soft'' Cost‐control Measures in Healthcare Organizations: Evidence from Preferred Drug Policies in Germany},
  year = 	{2021},
  month = 	{Nov},
  day = 	{10},
  volume = 	{2021},
  number = 	{08},
  keywords = 	{Cost-control; Healthcare; Practice Style; Difference-in-differences},
  abstract = 	{The purpose of the CINCH working paper series is to disseminate research in health economics encourage discussion in the fields of economic policy and competition in the health care sector. The series is targeted towards publishing ongoing high-quality research covering a wide range of topics within health economics, including theoretical, empirical and experimental contributions. Working papers should be full papers. The working paper series reflects the interests of CINCH such that econometric or experimental methods should form a significant component of the paper.},
  note = 	{Template-type: ReDIF-Series 1.0
Name: CINCH Working Paper Series (since 2020) 
Provider-Name: Duisburg-Essen University Library, DuEPublico 
Provider-Homepage: https://cinch.uni-due.de/ 
Provider-Institution: RePEc:edi:cinchde 
Maintainer-Name: DuEPublico 
Maintainer-Email: duepublico.ub@uni-due.de 
ISSN: 2199-8744 
Predecessor: RePEc:duh:wpaper 
Type: ReDIF-Paper 
Handle: RePEc:ajt:wcinch},
  note = 	{Template-Type: ReDIF-Paper 1.0
Author-Name: Avdic, Daniel
Author-Name-First: Daniel
Author-Name-Last: Avdic
Author-Name: Blankart, Katharina
Author-Name-First: Katharina
Author-Name-Last: Blankart
Title: A Hard Look at ``Soft'' Cost‐control Measures in Healthcare Organizations: Evidence from Preferred Drug Policies in Germany
Abstract: Cost‐control interventions that target physicians' clinical discretion are common in healthcare, but evidence on their efficacy is scarce; in particular for ``soft'' policies when liability is unlikely to be enforced by the regulator. We study the effectiveness of preferred drug policies (minimum prescription quotas of specific ``preferred'' drugs) in altering physicians practice styles within the high volume drug class of HMG‐CoA‐reductase inhibitors (statins) in the German statutory health insurance system. Using a nationally representative panel of ambulatory care physicians between 2011 and 2014, we exploit the decentralized institutional setting to estimate physician responses to variation in preferred drug policies across regional physician associations over time in a generalized difference‐in‐differences design. Results show that although the cost‐control mechanism increases average policy adherence, this effect is mainly driven by physicians with initially high use rates of preferred drugs. We argue that such misdirection may limit the policy's usefulness in reducing inappropriate practice variation among healthcare providers.
Keywords: Cost-control, Healthcare, Practice Style, Difference-in-differences
Creation-Date: 2021-11-10
DOI: 10.17185/duepublico/74978
File-URL: https://duepublico2.uni-due.de/servlets/MCRFileNodeServlet/duepublico{\_}derivate{\_}00074712/CINCH{\_}Series{\_}2021{\_}08.pdf
File-Format: application/pdf
File-Size: 10815801
Handle: RePEc:ajt:wcinch:74978},
  issn = 	{2199-8744},
  doi = 	{10.17185/duepublico/74978},
  url = 	{https://duepublico2.uni-due.de/receive/duepublico_mods_00074978},
  url = 	{https://doi.org/10.17185/duepublico/74978},
  url = 	{https://doi.org/10.17185/duepublico/70887},
  file = 	{:https://duepublico2.uni-due.de/servlets/MCRFileNodeServlet/duepublico_derivate_00074712/CINCH_Series_2021_08.pdf:PDF},
  language = 	{en}
}