Encyclopedia of Public Health

2008 Edition
| Editors: Wilhelm Kirch

Regulatory Mechanisms

  • Stefan Greß
Reference work entry
DOI: https://doi.org/10.1007/978-1-4020-5614-7_2965




Market failures would be imminent in most unregulated health care markets. Thus, regulatory mechanisms influence the way health care systems are financed and the way demand and supply in health care systems are determined. On the supply side, regulatory mechanisms strive to solve agency problems in the relationship between patients and health care professionals by introducing payment systems. However, little progress has made in designing payment schemes that encourage physicians to act as perfect agents for their patients as well as for third-party payers .

Basic Characteristics

Designers of health care systems around the world use a variety of regulatory mechanisms in order to overcome market failures that would be imminent in unregulated health care markets. Competitive health insurance systems need to overcome  adverse selection. Comprehensive coverage leads to  moral hazardand a relationship between patient and physician that has severe agency...

This is a preview of subscription content, log in to check access.


  1. 1.
    Engström S, Foldevi M, Borgquist L (2001) Is general practice effective? Scandinav J Prim Heal Care 19:131–44Google Scholar
  2. 2.
    Gosden T, Forland F, Kristiansen IS, Sutton M, Leese B, Giffrida A, Sergison M, Pedersen L (2001) Impact of payment method on behavior of primary care physicians. J Heal Serv Res Policy 6:44–55CrossRefGoogle Scholar
  3. 3.
    Gosden T, Williams J, Petchey R, Leese B, Sibbald B (2002) Salaried contracts in UK general practice: a study of job satisfaction and stress. J Heal Serv Res Policy 7:26–33CrossRefGoogle Scholar
  4. 4.
    Greß S, Delnoij D, Groenewegen P (2006) Managing primary care behaviour through payment systems and financial incentives. In: Boerma W, Rico A, Saltman R (ed) Primary care in the driver's seat? Organizational reform in European primary care. Open University Press, London, pp 184–200Google Scholar
  5. 5.
    Hutchinson B, Birch JHS, Lomas J, Walter SD, Eyles J, Stratford-Devai F (2000) Needs-based primary medical care capitation: Development and evaluation of alternative approaches. Heal Care Manag Sci 3:89–99CrossRefGoogle Scholar
  6. 6.
    Lynch M (1998) Financial incentives and primary care provision in Britain: Do General Practitioners maximse their income? In: Zweifel P (ed) Health, the medical profession and regulation. Kluwer Academic Publishers, Boston/Dordrecht/London, pp 191–210Google Scholar
  7. 7.
    Rice T (2006) The physician as the patient's agent. In: Jones A (ed) The Elgar Companion to Health Economcis. Edward Elgar Publishing, Cheltenham/Northampton, pp 261–278Google Scholar
  8. 8.
    Robinson J (2001) Theory and Practice in the Design of Physician Payment Systems. Milbank Quart 79:149–177CrossRefGoogle Scholar
  9. 9.
    Rosenthal M, Fernandopulle RH, Song R, Landon B (2004) Paying for quality: providers' incentives for quality improvement. Heal Aff 23:127–141CrossRefGoogle Scholar
  10. 10.
    Rosenthal MB, Frank RG, Li Z, Epstein AM (2005) From Concept to Practice: Early Experience with Pay‐for‐Performance. J Am Med Assoc 294:1788–1793CrossRefGoogle Scholar

Copyright information

© Springer-Verlag 2008

Authors and Affiliations

  • Stefan Greß
    • 1
  1. 1.Health Services Research and Health Economics, Department of Health SciencesUniversity of Applied Sciences FuldaFuldaGermany