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The effect of differential eligibility for free GP services on GP utilisation in Ireland

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  • Nolan, Anne
  • Smith, Samantha

Abstract

Internationally, there is extensive empirical evidence that a strong primary care-led health system is associated with improved health outcomes, increased quality of care, decreased health inequalities and lower overall health-care costs. Within primary care, factors influencing access to, and utilisation of, general practitioner (GP) services have been widely examined and this paper focuses on the role of user financial incentives. In particular, user charges for health care have been observed to deter health-care utilisation. Relative to other countries, the Irish health-care system is unusual in that the majority of the population are required to pay out-of-pocket for GP care. However, in 2005 the Irish government extended eligibility for free GP care to a further small subset of the population. Using micro-data from a nationally representative survey of the population in 2007, this paper analyses the impact of differential coverage of free GP services on GP utilisation in Ireland. Results from multivariate regression analysis indicate that GP utilisation is significantly more likely in the context of free GP care, controlling for a range of demographic, socio-economic and health factors. Interpretation of the results for the new category of coverage is complicated by possible pent-up demand and selection effects.

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Bibliographic Info

Article provided by Elsevier in its journal Social Science & Medicine.

Volume (Year): 74 (2012)
Issue (Month): 10 ()
Pages: 1644-1651

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Handle: RePEc:eee:socmed:v:74:y:2012:i:10:p:1644-1651

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Related research

Keywords: GP services; Utilisation; User fees; Financial incentives; Ireland;

References

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  1. Sara Allin & Jeremiah Hurley, 2008. "Inequity in Publicly Funded Physician Care: What Is The Role Of Private Prescription Drug Insurance?," Centre for Health Economics and Policy Analysis Working Paper Series, Centre for Health Economics and Policy Analysis (CHEPA), McMaster University, Hamilton, Canada 2008-02, Centre for Health Economics and Policy Analysis (CHEPA), McMaster University, Hamilton, Canada.
  2. Deininger, Klaus & Mpuga, Paul, 2004. "Economic and Welfare Effects of the Abolition of Health User Fees : Evidence from Uganda," Policy Research Working Paper Series 3276, The World Bank.
  3. Mark Stabile, 2001. "Private insurance subsidies and public health care markets: evidence from Canada," Canadian Journal of Economics, Canadian Economics Association, vol. 34(4), pages 921-942, November.
  4. Starfield, Barbara & Shi, Leiyu, 2002. "Policy relevant determinants of health: an international perspective," Health Policy, Elsevier, vol. 60(3), pages 201-218, June.
  5. 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, Elsevier, vol. 68(8), pages 1432-1438, April.
  6. Cumming, Jacqueline & Mays, Nicholas, 2011. "New Zealand’s Primary Health Care Strategy: early effects of the new financing and payment system for general practice and future challenges," Health Economics, Policy and Law, Cambridge University Press, Cambridge University Press, vol. 6(01), pages 1-21, January.
  7. Samantha Smith, 2010. "The Irish ‘health basket’: a basket case?," The European Journal of Health Economics, Springer, Springer, vol. 11(3), pages 343-350, June.
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Cited by:
  1. Layte, Richard & Nolan, Anne, 2013. "Income-Related Inequity in the Use of GP Services: A Comparison of Ireland and Scotland," Papers, Economic and Social Research Institute (ESRI) WP454, Economic and Social Research Institute (ESRI).

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