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The impact of transitions in insurance coverage on GP visiting among children in Ireland

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  • Nolan, Anne
  • Layte, Richard

Abstract

The use of direct out-of-pocket payments to finance general practitioner (GP) care by the majority of the population in Ireland is unusual in a European context. Currently, approximately 40 per cent of the population have means-tested access to free GP care, while the remainder must pay the full out-of-pocket cost. In this paper, we use nationally representative data from the Growing up in Ireland (GUI) study to examine the impact of transitions in insurance coverage on GP utilisation among children. GUI surveys two cohorts of nearly 20,000 children (aged 9 months and 9 years at baseline); we use data from the first two waves of each cohort (which covers the period 2007–2012). Using difference-in-difference propensity score matching methods, we find significant effects of changes in public health insurance coverage on GP utilisation (i.e., introducing user fees reduces utilisation, while removing them increases utilisation). The results have direct implications for current Irish health policy, and add to the international literature on the effects of insurance on healthcare utilisation.

Suggested Citation

  • Nolan, Anne & Layte, Richard, 2017. "The impact of transitions in insurance coverage on GP visiting among children in Ireland," Social Science & Medicine, Elsevier, vol. 180(C), pages 94-100.
  • Handle: RePEc:eee:socmed:v:180:y:2017:i:c:p:94-100
    DOI: 10.1016/j.socscimed.2017.03.026
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    1. Andrea Ichino & Fabrizia Mealli & Tommaso Nannicini, 2008. "From temporary help jobs to permanent employment: what can we learn from matching estimators and their sensitivity?," Journal of Applied Econometrics, John Wiley & Sons, Ltd., vol. 23(3), pages 305-327.
    2. Janet Currie & Jonathan Gruber, 1996. "Health Insurance Eligibility, Utilization of Medical Care, and Child Health," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 111(2), pages 431-466.
    3. 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.
    4. Dolores De La Mata, 2012. "The Effect Of Medicaid Eligibility On Coverage, Utilization, And Children'S Health," Health Economics, John Wiley & Sons, Ltd., vol. 21(9), pages 1061-1079, September.
    5. Markus Frölich, 2004. "Programme Evaluation with Multiple Treatments," Journal of Economic Surveys, Wiley Blackwell, vol. 18(2), pages 181-224, April.
    6. Dafny, Leemore & Gruber, Jonathan, 2005. "Public insurance and child hospitalizations: access and efficiency effects," Journal of Public Economics, Elsevier, vol. 89(1), pages 109-129, January.
    7. David Card & Lara D. Shore-Sheppard, 2004. "Using Discontinuous Eligibility Rules to Identify the Effects of the Federal Medicaid Expansions on Low-Income Children," The Review of Economics and Statistics, MIT Press, vol. 86(3), pages 752-766, August.
    8. Mark Stabile, 2001. "Private insurance subsidies and public health care markets: evidence from Canada," Canadian Journal of Economics/Revue canadienne d'économique, John Wiley & Sons, vol. 34(4), pages 921-942, November.
    9. Laura R. Wherry & Sarah Miller & Robert Kaestner & Bruce D. Meyer, 2018. "Childhood Medicaid Coverage and Later-Life Health Care Utilization," The Review of Economics and Statistics, MIT Press, vol. 100(2), pages 287-302, May.
    10. Currie, Janet, 2000. "Child health in developed countries," Handbook of Health Economics, in: A. J. Culyer & J. P. Newhouse (ed.), Handbook of Health Economics, edition 1, volume 1, chapter 19, pages 1053-1090, Elsevier.
    11. 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.
    12. Boudreaux, Michel H. & Golberstein, Ezra & McAlpine, Donna D., 2016. "The long-term impacts of Medicaid exposure in early childhood: Evidence from the program's origin," Journal of Health Economics, Elsevier, vol. 45(C), pages 161-175.
    13. Moran, John R. & Short, Pamela Farley & Hollenbeak, Christopher S., 2011. "Long-term employment effects of surviving cancer," Journal of Health Economics, Elsevier, vol. 30(3), pages 505-514, May.
    14. Currie, Janet & Decker, Sandra & Lin, Wanchuan, 2008. "Has public health insurance for older children reduced disparities in access to care and health outcomes?," Journal of Health Economics, Elsevier, vol. 27(6), pages 1567-1581, December.
    15. James J. Heckman & Hidehiko Ichimura & Petra E. Todd, 1997. "Matching As An Econometric Evaluation Estimator: Evidence from Evaluating a Job Training Programme," The Review of Economic Studies, Review of Economic Studies Ltd, vol. 64(4), pages 605-654.
    16. 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.
    17. Wren, Maev-Ann & Connolly, Sheelagh & Cunningham, Nathan, 2015. "An Examination of the Potential Costs of Universal Health Insurance in Ireland," Research Series, Economic and Social Research Institute (ESRI), number RS45, June.
    18. Palmer, Michael & Mitra, Sophie & Mont, Daniel & Groce, Nora, 2015. "The impact of health insurance for children under age 6 in Vietnam: A regression discontinuity approach," Social Science & Medicine, Elsevier, vol. 145(C), pages 217-226.
    19. Yang Song & Wenkai Sun, 2016. "Health Consequences of Rural‐to‐Urban Migration: Evidence from Panel Data in China," Health Economics, John Wiley & Sons, Ltd., vol. 25(10), pages 1252-1267, October.
    20. Richard Layte & Anne Nolan, 2015. "Income-related inequity in the use of GP services by children: a comparison of Ireland and Scotland," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 16(5), pages 489-506, June.
    21. Sara Allin & Jeremiah Hurley, 2009. "Inequity in publicly funded physician care: what is the role of private prescription drug insurance?," Health Economics, John Wiley & Sons, Ltd., vol. 18(10), pages 1218-1232, October.
    22. Samantha Smith, 2010. "The Irish ‘health basket’: a basket case?," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 11(3), pages 343-350, June.
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    Cited by:

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    2. Connolly, Sheelah & Keegan, Conor & O'Malley, Seamus & Regan, Mark, 2022. "Extending eligibility for general practitioner care in Ireland: cost implications," Research Series, Economic and Social Research Institute (ESRI), number RS156, June.
    3. Eriksen, Steffen & Wiese, Rasmus, 2019. "Policy induced increases in private healthcare financing provide short-term relief of total healthcare expenditure growth: Evidence from OECD countries," European Journal of Political Economy, Elsevier, vol. 59(C), pages 71-82.
    4. Ann, Kirby & Murphy, Aileen, 2022. "Would universal general practitioner care impact Irish adolescents’ utilisation?," Health Policy, Elsevier, vol. 126(7), pages 652-660.
    5. 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.
    6. Walsh, Brendan & Keegan, Conor & Brick, Aoife & Connolly, Sheelah & Bergin, Adele & Wren, Maev-Ann & Lyons, Seán & Hill, Leonie & Smith, Samantha, 2021. "Projections of expenditure for primary, community and long-term care Ireland, 2019–2035, based on the Hippocrates model," Research Series, Economic and Social Research Institute (ESRI), number RS126, June.
    7. Walsh, Brendan & Nolan, Anne & Brick, Aoife & Keegan, Conor, 2019. "Did the expansion of free GP care impact demand for Emergency Department attendances? A difference-in-differences analysis," Social Science & Medicine, Elsevier, vol. 222(C), pages 101-111.
    8. McDonnell, Thérèse & Nicholson, Emma & Bury, Gerard & Collins, Claire & Conlon, Ciara & Denny, Kevin & O'Callaghan, Michael & McAuliffe, Eilish, 2022. "Policy of free GP care for children under 6 years: The impact on daytime and out-of-hours general practice," Social Science & Medicine, Elsevier, vol. 296(C).
    9. Walsh, Brendan & Lyons, Seán, 2021. "Demand for the Statutory Home Care Scheme," Research Series, Economic and Social Research Institute (ESRI), number RS122, June.

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