IDEAS home Printed from https://ideas.repec.org/a/eee/jhecon/v72y2020ics0167629619310999.html
   My bibliography  Save this article

Free GP care and psychological health: Quasi-experimental evidence from Ireland

Author

Listed:
  • Ma, Yuanyuan
  • Nolan, Anne
  • Smith, James P.

Abstract

There is considerable ambiguity in the literature on the effect of health insurance on health. While the majority of previous analyses have examined physical health outcomes, analyses of the broader dimensions of health such as psychological health and wellbeing have been less frequent. Using data from the Irish Longitudinal Study on Ageing (TILDA) and a difference-in-differences research design, we examine the impact of free general practitioner (GP) care on psychological health among the older population and explore potential mechanisms. While we find no impact of public health insurance expansions on quality of life, life satisfaction, depression, and worry, the removal of GP fees for all those 70+ leads to a significantly lower level of perceived stress. The impact is mainly driven by poorer, sicker and single individuals. Further analyses show that removing GP fees leads to greater access to GP services and lower levels of financial stress.

Suggested Citation

  • Ma, Yuanyuan & Nolan, Anne & Smith, James P., 2020. "Free GP care and psychological health: Quasi-experimental evidence from Ireland," Journal of Health Economics, Elsevier, vol. 72(C).
    • Handle: RePEc:eee:jhecon:v:72:y:2020:i:c:s0167629619310999
    DOI: 10.1016/j.jhealeco.2020.102351
    as

    Download full text from publisher

    File URL: http://www.sciencedirect.com/science/article/pii/S0167629619310999
    Download Restriction: Full text for ScienceDirect subscribers only
    File URL: https://libkey.io/10.1016/j.jhealeco.2020.102351?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    As the access to this document is restricted, you may want to search for a different version of it.

    References listed on IDEAS

    as
    1. Joseph G. Altonji & Todd E. Elder & Christopher R. Taber, 2005. "Selection on Observed and Unobserved Variables: Assessing the Effectiveness of Catholic Schools," Journal of Political Economy, University of Chicago Press, vol. 113(1), pages 151-184, February.
    2. Sheelah Connolly & Anne Nolan & Brendan Walsh & Maev-Ann Wren, 2018. "Universal GP Care in Ireland: Potential Cost Implications," The Economic and Social Review, Economic and Social Studies, vol. 49(1), pages 93-109.
    3. Barbaresco, Silvia & Courtemanche, Charles J. & Qi, Yanling, 2015. "Impacts of the Affordable Care Act dependent coverage provision on health-related outcomes of young adults," Journal of Health Economics, Elsevier, vol. 40(C), pages 54-68.
    4. Alberto Abadie & Susan Athey & Guido W Imbens & Jeffrey M Wooldridge, 2023. "When Should You Adjust Standard Errors for Clustering?," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 138(1), pages 1-35.
    5. Hitoshi Shigeoka, 2014. "The Effect of Patient Cost Sharing on Utilization, Health, and Risk Protection," American Economic Review, American Economic Association, vol. 104(7), pages 2152-2184, July.
    6. Nicolas R. Ziebarth, 2018. "Social Insurance and Health," Contributions to Economic Analysis, in: Health Econometrics, volume 127, pages 57-84, Emerald Group Publishing Limited.
    7. He, Guojun & Liu, Tong & Zhou, Maigeng, 2020. "Straw burning, PM2.5, and death: Evidence from China," Journal of Development Economics, Elsevier, vol. 145(C).
    8. Hudson, Eibhlin & Nolan, Anne, 2015. "Public healthcare eligibility and the utilisation of GP services by older people in Ireland," The Journal of the Economics of Ageing, Elsevier, vol. 6(C), pages 24-43.
    9. Patrick Flavin, 2018. "State Medicaid Expansion and Citizens’ Quality of Life," Social Science Quarterly, Southwestern Social Science Association, vol. 99(2), pages 616-625, June.
    10. Amy Finkelstein & Sarah Taubman & Bill Wright & Mira Bernstein & Jonathan Gruber & Joseph P. Newhouse & Heidi Allen & Katherine Baicker, 2012. "The Oregon Health Insurance Experiment: Evidence from the First Year," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 127(3), pages 1057-1106.
    11. David Madden & Anne Nolan & Brian Nolan, 2005. "GP reimbursement and visiting behaviour in Ireland," Health Economics, John Wiley & Sons, Ltd., vol. 14(10), pages 1047-1060, October.
    12. Shinsuke Tanaka, 2014. "Does Abolishing User Fees Lead to Improved Health Status? Evidence from Post-apartheid South Africa," American Economic Journal: Economic Policy, American Economic Association, vol. 6(3), pages 282-312, August.
    13. Yuanyuan Ma & Anne Nolan, 2017. "Public Healthcare Entitlements and Healthcare Utilisation among the Older Population in Ireland," Health Economics, John Wiley & Sons, Ltd., vol. 26(11), pages 1412-1428, November.
    14. Manning, Willard G, et al, 1987. "Health Insurance and the Demand for Medical Care: Evidence from a Randomized Experiment," American Economic Review, American Economic Association, vol. 77(3), pages 251-277, June.
    15. Jonathan Gruber & Benjamin D. Sommers, 2019. "The Affordable Care Act’s Effects on Patients, Providers and the Economy: What We’ve Learned So Far," NBER Working Papers 25932, National Bureau of Economic Research, Inc.
    16. Katherine Baicker & Dana Goldman, 2011. "Patient Cost-Sharing and Healthcare Spending Growth," Journal of Economic Perspectives, American Economic Association, vol. 25(2), pages 47-68, Spring.
    17. Jonathan Gruber & Benjamin D. Sommers, 2019. "The Affordable Care Act'S Effects On Patients, Providers, And The Economy: What We'Ve Learned So Far," Journal of Policy Analysis and Management, John Wiley & Sons, Ltd., vol. 38(4), pages 1028-1052, September.
    18. Nolan, Anne & Nolan, Brian, 2007. "The Utilisation of GP Services," Book Chapters, in: Nolan, Brian (ed.),The Provision and Use of Health Services, Health Inequalities and Health and Social Gain, Economic and Social Research Institute (ESRI).
    19. Layte, Richard & Nolan, Anne & McGee, Hannah & O'Hanlon, Ann, 2009. "Do consultation charges deter general practitioner use among older people? A natural experiment," Social Science & Medicine, Elsevier, vol. 68(8), pages 1432-1438, April.
    20. Burke, Sara & Barry, Sarah & Siersbaek, Rikke & Johnston, Bridget & Ní Fhallúin, Maebh & Thomas, Steve, 2018. "Sláintecare – A ten-year plan to achieve universal healthcare in Ireland," Health Policy, Elsevier, vol. 122(12), pages 1278-1282.
    21. Keeler, Emmett B. & Rolph, John E., 1988. "The demand for episodes of treatment in the health insurance experiment," Journal of Health Economics, Elsevier, vol. 7(4), pages 337-367, December.
    22. Ayyagari, Padmaja & Shane, Dan M., 2015. "Does prescription drug coverage improve mental health? Evidence from Medicare Part D," Journal of Health Economics, Elsevier, vol. 41(C), pages 46-58.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Nowakowski, Adam & Oswald. Andrew J, 2020. "Do Europeans Care about Climate Change? An Illustration of the Importance of Data on Human Feelings," The Warwick Economics Research Paper Series (TWERPS) 1303, University of Warwick, Department of Economics.
    2. Walsh, Brendan & Doorley, Karina, 2022. "Occupations and health," Papers BP2023/3, Economic and Social Research Institute (ESRI).
    3. Ann, Kirby & Murphy, Aileen, 2022. "Would universal general practitioner care impact Irish adolescents’ utilisation?," Health Policy, Elsevier, vol. 126(7), pages 652-660.
    4. Nowakowski, Adam & Oswald, Andrew J, 2020. "Do Europeans Care about Climate Change? An Illustration of the Importance of Data on Human Feelings," CAGE Online Working Paper Series 510, Competitive Advantage in the Global Economy (CAGE).

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Yuanyuan Ma & Anne Nolan, 2017. "Public Healthcare Entitlements and Healthcare Utilisation among the Older Population in Ireland," Health Economics, John Wiley & Sons, Ltd., vol. 26(11), pages 1412-1428, November.
    2. Kurt Lavetti & Thomas DeLeire & Nicolas R. Ziebarth, 2023. "How do low‐income enrollees in the Affordable Care Act marketplaces respond to cost‐sharing?," Journal of Risk & Insurance, The American Risk and Insurance Association, vol. 90(1), pages 155-183, March.
    3. Mohan, Gretta & Nolan, Anne & Lyons, Seán, 2019. "An investigation of the effect of accessibility to General Practitioner services on healthcare utilisation among older people," Social Science & Medicine, Elsevier, vol. 220(C), pages 254-263.
    4. Toshiaki Iizuka & Hitoshi Shigeoka, 2018. "Free for Children? Patient Cost-sharing and Healthcare Utilization," NBER Working Papers 25306, National Bureau of Economic Research, Inc.
    5. Naimi Johansson & Niklas Jakobsson & Mikael Svensson, 2019. "Effects of primary care cost-sharing among young adults: varying impact across income groups and gender," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 20(8), pages 1271-1280, November.
    6. Richard Layte & Anne Nolan, 2015. "Eligibility for free GP care and the utilisation of GP services by children in Ireland," International Journal of Health Economics and Management, Springer, vol. 15(1), pages 3-27, March.
    7. Hudson, Eibhlin & Nolan, Anne, 2015. "Public healthcare eligibility and the utilisation of GP services by older people in Ireland," The Journal of the Economics of Ageing, Elsevier, vol. 6(C), pages 24-43.
    8. Nicolas R. Ziebarth, 2018. "Social Insurance and Health," Contributions to Economic Analysis, in: Health Econometrics, volume 127, pages 57-84, Emerald Group Publishing Limited.
    9. Powell, David & Goldman, Dana, 2021. "Disentangling moral hazard and adverse selection in private health insurance," Journal of Econometrics, Elsevier, vol. 222(1), pages 141-160.
    10. Michael R.M. Abrigo & Timothy J. Halliday & Teresa Molina, 2022. "Expanding health insurance for the elderly of the Philippines," Journal of Applied Econometrics, John Wiley & Sons, Ltd., vol. 37(3), pages 500-520, April.
    11. Hirotaka Kato & Rei Goto & Taishi Tsuji & Katsunori Kondo, 2022. "The effects of patient cost-sharing on health expenditure and health among older people: Heterogeneity across income groups," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 23(5), pages 847-861, July.
    12. Feng Huang & Li Gan`, 2017. "The Impacts of China's Urban Employee Basic Medical Insurance on Healthcare Expenditures and Health Outcomes," Health Economics, John Wiley & Sons, Ltd., vol. 26(2), pages 149-163, February.
    13. Fukushima, Kazuya & Mizuoka, Sou & Yamamoto, Shunsuke & Iizuka, Toshiaki, 2016. "Patient cost sharing and medical expenditures for the Elderly," Journal of Health Economics, Elsevier, vol. 45(C), pages 115-130.
    14. Michio Yuda, 2018. "The medical assistance system and inpatient health care provision: Empirical evidence from short-term hospitalizations in Japan," PLOS ONE, Public Library of Science, vol. 13(10), pages 1-14, October.
    15. Takaku, Reo, 2017. "The Effect Of Patient Cost Sharing On Health Care Utilization Among Low-Income Children," Hitotsubashi Journal of Economics, Hitotsubashi University, vol. 58(1), pages 69-88, June.
    16. Nilsson, Anton & Paul, Alexander, 2018. "Patient cost-sharing, socioeconomic status, and children's health care utilization," Journal of Health Economics, Elsevier, vol. 59(C), pages 109-124.
    17. Paul, Alexander & Nilsson, Anton, 2014. "The Effect of Copayments on Children's and Adolescents' Demand for Medical Care," VfS Annual Conference 2014 (Hamburg): Evidence-based Economic Policy 100403, Verein für Socialpolitik / German Economic Association.
    18. Takaku, Reo, 2016. "Effects of reduced cost-sharing on children's health: Evidence from Japan," Social Science & Medicine, Elsevier, vol. 151(C), pages 46-55.
    19. Charles Courtemanche & James Marton & Benjamin Ukert & Aaron Yelowitz & Daniela Zapata, 2018. "Early Effects of the Affordable Care Act on Health Care Access, Risky Health Behaviors, and Self‐Assessed Health," Southern Economic Journal, John Wiley & Sons, vol. 84(3), pages 660-691, January.
    20. Tal Gross & Timothy J. Layton & Daniel Prinz, 2022. "The Liquidity Sensitivity of Healthcare Consumption: Evidence from Social Security Payments," American Economic Review: Insights, American Economic Association, vol. 4(2), pages 175-190, June.

    More about this item

    Keywords

    Public health insurance; Psychological health; Quasi-experiment; Ageing;
    All these keywords.

    JEL classification:

    • C22 - Mathematical and Quantitative Methods - - Single Equation Models; Single Variables - - - Time-Series Models; Dynamic Quantile Regressions; Dynamic Treatment Effect Models; Diffusion Processes
    • I13 - Health, Education, and Welfare - - Health - - - Health Insurance, Public and Private

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:eee:jhecon:v:72:y:2020:i:c:s0167629619310999. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Catherine Liu (email available below). General contact details of provider: http://www.elsevier.com/locate/inca/505560 .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.