In forming strategies to improve the macro performance of health care systems, effective interaction between the public and private service provisions is considered an important aspect of institutional design. Recent economic research has provided valuable insights into the significance of this interaction. We study the market entry decisions of private physicians in the outpatient health care sector inAustria by applying an entry=exit model at two different spatial levels of aggregation and using data from the time period 2002-2008. By estimating a Poisson panel data model with community=district fixed effects, we find a significantly negative effect of existing physician capacities in a specialty, both in the public and private sectors, on the entry of new private physicians. On the contrary, we find a significantly positive effect of existing private general practitioners on the entry of private specialists. These findings indicate that private physicians tend to (i) compensate for regional differences in public outpatient capacities, and (ii) establish cooperative networks where they collaborate with other private physicians in the local market.
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Abraham J. M. Gaynor M. and Vogt W. B. (2007). Entry and Competition in Local Hospital Markets. The Journal of Industrial Economics 55 265-288.
Al-Amin M. Zinn J. Rosko M. D. and Aaronson W. (2010). Specialty hospital market proliferation: Strategic implications for general hospitals. Health Care Management Review 35(4) 294-300.
Al-Amin M. and Housman M. (2012). Ambulatory surgery center and general hospital competition: entry decisions and strategic choices. Health Care Management Review 37(3) 223-234.
Atella V. Deb P. (2008). Are Primary Care Physicians Public and Private Sector Specialists Substitutes or Complements? Evidence from a Simultaneous Equations Model for Count Data. Journal of Health Economics 27(3) 770-785.
Atella V. et al. (2004). Determinants of Access to Physician Services in Italy: A Latent Class Seemingly Unrelated Probit Approach. Health Economics 13(7) 657-668.
Bresnahan T. F. and Reiss P. C. (1988). Do Entry Conditions Vary Across Markets? Brookings Papers on Economic Activity 99 977-1009.
Bresnahan T. F. and Reiss P. C. (1990). Entry in Monopoly Markets. Review of Economic Studies 57 531-53.
Bresnahan T. F. and Reiss P. C. (1991). Entry and Competition in Concentrated Markets.Journal of Political Economy 3 833-882.
Cameron A. C. and Trivedi P. K. (2005). Microeconometrics - Methods and Applications.Cambridge: Cambridge University Press.
Chappell W. F. Kimenyi M. S. and Mayer W. J. (1990). A Poisson Probability Model of Entry and Market Structure with an Application to U.S. Industries during 1972-77.Southern Economic Journal 56 918-927.
Capps C. Dranove D. and Lindrooth R. C. (2009). Hospital Closure and Economic Efficiency. Journal of Health Economics 29 87-109.
Duetsch L. (1984). Entry and the Extent of Multiplant Operations. The Journal of Industrial Economics 32 477-488.
Dunne T. Roberts M. and Samuelson L. (1988). Patterns of Firm Entry and Exit in U.S.Manufacturing Industries. Journal of Law and Economics 32 233-271.
Dunne T. and Roberts M. (1991). Variation in Producer Turnover Across U.S. Manufacturing Industries. In P.A. Geroski P.A. and Schwalbach J. (eds). Entry and Market Contestability Oxford: Basil Blackwell 187-203.
Fabbri D. Monfardini C. (2003). Public vs. Private Health Care Services Demand in Italy. Giornale degli Economisti 62(1) 93-123.
Gächter M. Schwazer P. Theurl E. and Winner H. (2012). Physician Density in a Two- Tiered Health Care System. Health Policy 106 257-268.
Geroski P. K. (1991). Market Dynamics and Entry. Oxford: Basil Blackwell.
Göschl CD-MED. (2002-2008). Handbuch für die Sanitätsberufe Österreichs. Wien: Verlag Dieter Göschl.
Hirschey M. (1981). The Effect of Advertising on Industrial Mobility. The Journal of Business 54 329-339.
Hofmarcher M. M. and Rack H. M. (2006). Austria Health System Review. In Riesberg A. (ed.). Health Systems in Transition 8(3) 2006.
Mayer W. J. and Chappell W. F. (1992). Determinants of Entry and Exit: An Application of the Compounded Bivariate Poisson Distribution to U.S. Industries 1972-77. Southern Economic Journal 58 770-778.
Mazzeo M. (2002). Product Choice and Oligopoly Market Structure. RAND Journal of Economics 33(2) 221-242.
Orr D. (1974a). The Determinants of Entry: A Study of the Canadian Manufacturing Industries. The Review of Economics and Statistics 56 58-65.
Orr D. (1974b). The Economic Determinants of Entry into Canadian Banking: 1963-7.The Canadian Journal of Economics 7 82-99.
Propper C. (2000). The Demand for Private Health Care in the UK. Journal of Health Economics 19(6) 855-76.
Rosenbaum D. (1993). Profit Entry and Changes in Concentration. International Journal of Industrial Organization 11 185-203.
Schaumans C. and Verboven F. (2008). Entry and Regulation: Evidence from Health Care Professions. RAND Journal of Economics 39 949-972. Siegfried J. J. and Evans L. B. (1994). Empirical Studies on Entry and Exit: A Survey of the Evidence. Review of Industrial Organizations 11 167-178.
Sleuwaegen L. and DehandschutterW. (1991). Entry and exit in Belgian Manufacturing.In Geroski P.A. and Schwalbach J. (eds). Entry and Market Contestability Oxford: Basil Blackwell 111-142.