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Does Abolishing a Copayment Increase Doctor Visits? A Comparative Case Study

Author

Listed:
  • Haaga Tapio
  • Kortelainen Mika

    (Finnish Institute for Health and Welfare (THL), Helsinki, Finland)

  • Böckerman Petri

    (University of Jyväskylä, Jyväskylä, Finland)

  • Tukiainen Janne

    (University of Turku, Turku, Finland)

Abstract

Insurance coverage increases health care consumption, but less is known whether moderate copayments affect adults’ primary care utilization in a system characterized by gatekeeping. We analyze whether abolishing a 14-euro copayment for visits to general practitioners (GP) in Helsinki, the capital of Finland, increased the number of GP visits among adults and especially among low-income individuals. Using a difference-in-differences (DD) design and combining several administrative registers from 2011 to 2014, we find that the abolition is associated with only a small increase in GP visits (+0.04 visits annually, or +4.4 %, for all adults). The increase is driven by low-income adults (+0.06 visits, or +4.5 %, at the bottom 40 %). Although the point estimates are rather robustly positive, the conclusions regarding the statistical significance are sensitive to how we account for clustering in a setting characterized by only one treated cluster and a finite number of comparison clusters.

Suggested Citation

  • Haaga Tapio & Kortelainen Mika & Böckerman Petri & Tukiainen Janne, 2024. "Does Abolishing a Copayment Increase Doctor Visits? A Comparative Case Study," The B.E. Journal of Economic Analysis & Policy, De Gruyter, vol. 24(1), pages 187-204, January.
    • Handle: RePEc:bpj:bejeap:v:24:y:2024:i:1:p:187-204:n:2
    DOI: 10.1515/bejeap-2023-0056
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    More about this item

    Keywords

    cost-sharing; copayment; out-of-pocket costs; primary care use; general practitioner; difference-in-differences;
    All these keywords.

    JEL classification:

    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health
    • I14 - Health, Education, and Welfare - - Health - - - Health and Inequality
    • I13 - Health, Education, and Welfare - - Health - - - Health Insurance, Public and Private
    • H42 - Public Economics - - Publicly Provided Goods - - - Publicly Provided Private Goods
    • I11 - Health, Education, and Welfare - - Health - - - Analysis of Health Care Markets

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