ArticleThe European journal of health economics : HEPAC : health economics in prevention and care2025
Compliance with clinical guidelines: the role of incentives and competition between practitioners.
Article in The European journal of health economics : HEPAC : health economics in prevention and care, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
In this study we use a unit record, panel dataset, to examine the behaviour of clinicians under a chronic disease management program (CDMP) that is designed to improve care and slow the progression of chronic kidney disease (CKD). Using 8 years of quarterly data on the population of CKD patients (n = 44,686) in the Emilia-Romagna region of northern Italy, we analyse a setting where medical practitioners are agents who respond to the demands of two principals: their patient and the third-party payer. Exploiting detailed information on specialist visits and the concentration of general practitioners (GP) in local areas, as well as disease severity, we study how GPs on one side, and specialist nephrologists and cardiologists on the other comply with the CDMP guidelines, as may be predicted on the basis of a dual-agency approach. Our application of both multiple-treatment differences-in-differences (DID
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