Do consultation charges deter general practitioner use among older people? A natural experiment
Abstract
In the Republic of Ireland, approximately 30% of the population ('medical card patients') are entitled to free general practice services. Eligibility is determined primarily on the basis of an income means test. The remaining 70% of the population ('private patients') must pay the full cost of all general practitioner (GP) consultations. From July 2001, all those over 70 years of age are also entitled to a medical card, regardless of income. This change in the pricing of GP services in the Republic of Ireland in 2001 provides a natural experiment that allows for an examination of the influence of economic incentives on GP visiting behaviour. The purpose of this paper is to examine whether this change in pricing for GP care for those over 70 years of age in Ireland led to an increase in the utilisation of GP services among this group. Using data from two nationally representative surveys of the population over the age of 65 before and after the policy change, difference-in-difference two-step models of GP visiting behaviour are estimated. The results indicate that, while there is some limited evidence in favour of an increase in the probability of seeking GP care among those over 70 years of age after the policy change, there is no significant effect on the frequency of visits. Differences in the incentives facing both patients and GPs after the policy change can explain the latter result.Download Info
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Bibliographic Info
Article provided by Elsevier in its journal Social Science & Medicine.
Volume (Year): 68 (2009)
Issue (Month): 8 (April)
Pages: 1432-1438
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Related research
Keywords: General practice Utilisation Equity Older age Incentives Consultation charges General practitioner (GP) Ireland;References
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Citations
Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.Cited by:
- G. Fiorentini & M. Lippi Bruni & C. Ugolini, 2012.
"GPs and hospital expenditures. Should we keep expenditure containment programs alive?,"
Working Papers
wp829, Dipartimento Scienze Economiche, Universita' di Bologna.
- Fiorentini, Gianluca & Lippi Bruni, Matteo & Ugolini, Cristina, 2013. "GPs and hospital expenditures. Should we keep expenditure containment programs alive?," Social Science & Medicine, Elsevier, vol. 82(C), pages 10-20.
- Edel Doherty & Anne Dee & Ciaran O’Neill, 2012. "Estimating the Amount of Overweight and Obesity Related Health-Care Use in the Republic of Ireland Using SLÁN Data," The Economic and Social Review, Economic and Social Studies, vol. 43(2), pages 227â250.
- Layte, Richard & Nolan, Anne, 2009. "Improving Access to Primary Care in Ireland: Do GP Charges Matter?," Papers RB2009/2/1, Economic and Social Research Institute (ESRI).
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