The European Journal of Health Economics

, Volume 14, Issue 2, pp 267–276 | Cite as

Organisational determinants of production and efficiency in general practice: a population-based study

  • Kim Rose Olsen
  • Dorte Gyrd-Hansen
  • Torben Højmark Sørensen
  • Troels Kristensen
  • Peter Vedsted
  • Andrew Street
Original Paper



Shortage of general practitioners (GPs) and an increased political focus on primary care have enforced the interest in efficiency analysis in the Danish primary care sector. This paper assesses the association between organisational factors of general practices and production and efficiency.


We assume that production and efficiency can be modelled using a behavioural production function. We apply the Battese and Coelli (Empir Econ 20:325–332, 1995) estimator to accomplish a decomposition of exogenous variables to determine the production frontier and variables determining the individual GPs distance to this frontier. Two different measures of practice outputs (number of office visits and total production) were applied and the results compared.


The results indicate that nurses do not substitute GPs in the production. The production function exhibited constant returns to scale. The mean level of efficiency was between 0.79 and 0.84, and list size was the most important determinant of variation in efficiency levels.


Nurses are currently undertaking other tasks than GPs, and larger practices do not lead to increased production per GP. However, a relative increase in list size increased the efficiency. This indicates that organisational changes aiming to increase capacity in general practice should be carefully designed and tested.


General practice Efficiency Stochastic frontier analysis Economies of scale Input substitution 

JEL Classification

I12 C31 D22 


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Copyright information

© Springer-Verlag 2011

Authors and Affiliations

  • Kim Rose Olsen
    • 1
    • 2
    • 3
  • Dorte Gyrd-Hansen
    • 1
    • 2
  • Torben Højmark Sørensen
    • 1
  • Troels Kristensen
    • 2
    • 3
  • Peter Vedsted
    • 5
  • Andrew Street
    • 4
  1. 1.Danish Institute for Health Services ResearchCopenhagenDenmark
  2. 2.Research Unit of Health EconomicsUniversity of Southern DenmarkOdenseDenmark
  3. 3.Research Unit of General PracticeUniversity of Southern DenmarkOdenseDenmark
  4. 4.Center for Health EconomicsUniversity of YorkYorkUK
  5. 5.Research Unit of General PracticeAarhus UniversityAarhusDenmark

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