Patients often rely on the advice of their general practitioner (GP) to decide which treatment best fits their needs. Hospitals, in turn, might influence GPs’ referral decision through kickbacks. We present a model with a monopolistic hospital and competitive GPs who vary in the degree of altruism towards their heterogeneous patients and show that an equilibrium without crowding out exists that separates GPs into referrers and care providers. Naïve patients visit purely selfish (referring) GPs, while rational patients sort themselves between the two groups of GPs. Finally, we investigate the scope for regulation, including an optimal coinsurance rate.

中文翻译：

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利他主义看门人的生存：医疗市场的回扣

患者通常依靠其全科医生（GP）的建议来决定哪种治疗最适合他们的需求。反过来，医院可能会通过回扣影响全科医生的转诊决定。我们提出了一个具有垄断性医院和竞争性全科医生的模型，他们对异类患者的利他程度有所不同，并表明存在一种不拥挤的均衡状态，将全科医生分为推荐人和护理提供者。单纯的患者拜访纯粹是自私的（指的）全科医生，而理性的患者则将他们自己分类为两组全科医生。最后，我们研究了监管范围，包括最佳共同保险率。