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GP Utilisation in Northern Ireland - Exploiting the Gatekeeper Function

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Author Info

  • Pat McGregor

    (University of Ulster)

  • Pat McKee

    (University of Ulster)

  • Ciaran O’Neill

    (University of Ulster)

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    Abstract

    Using data from the Northern Ireland Household Panel survey we demonstrate that attendance at outpatients is determined solely by respondent health. This is consistent with the GP acting as a gatekeeper to other services. Attendance thus provides valuable information on illness severity. Splitting the sample into two statistically distinct groups, we estimate ordered probit regressions of GP utilisation with and without sample selection. The results indicate that ignoring outpatient attendance may result in misspecification. Further, if health is more fully measured, age becomes redundant as a determinant of utilisation and service supply, particularly accident and emergency use, is seen as a significant determinant in explaining GP visits.

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    File URL: http://www.esr.ie/Vol37_1/04_McGregor_article.pdf
    File Function: First version, 2006
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    Bibliographic Info

    Article provided by Economic and Social Studies in its journal Economic and Social Review.

    Volume (Year): 37 (2006)
    Issue (Month): 1 ()
    Pages: 71-90

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    Handle: RePEc:eso:journl:v:37:y:2006:i:1:p:71-90

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    Web page: http://www.esr.ie

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    1. Eddy van Doorslaer & Xander Koolman & Andrew M. Jones, 2004. "Explaining income-related inequalities in doctor utilisation in Europe," Health Economics, John Wiley & Sons, Ltd., vol. 13(7), pages 629-647.
    2. Starfield, Barbara & Shi, Leiyu, 2002. "Policy relevant determinants of health: an international perspective," Health Policy, Elsevier, vol. 60(3), pages 201-218, June.
    3. Sutton, Matthew & Carr-Hill, Roy & Gravelle, Hugh & Rice, Nigel, 1999. "Do measures of self-reported morbidity bias the estimation of the determinants of health care utilisation?," Social Science & Medicine, Elsevier, vol. 49(7), pages 867-878, October.
    4. Madden, David & Nolan, Anne & Nolan, Brian, 2004. "GP Reimbursement and Visiting Behaviour in Ireland," Papers HRBWP09, Economic and Social Research Institute (ESRI).
    5. Dunlop, Sheryl & Coyte, Peter C. & McIsaac, Warren, 2000. "Socio-economic status and the utilisation of physicians' services: results from the Canadian National Population Health Survey," Social Science & Medicine, Elsevier, vol. 51(1), pages 123-133, July.
    6. Nolan, Anne & Nolan, Brian, 2003. "A Cross-Sectional Analysis of the Utilisation of GP Services in Ireland: 1987-2001," Papers HRBWP01, Economic and Social Research Institute (ESRI).
    7. Winfried Pohlmeier & Volker Ulrich, 1995. "An Econometric Model of the Two-Part Decisionmaking Process in the Demand for Health Care," Journal of Human Resources, University of Wisconsin Press, vol. 30(2), pages 339-361.
    8. Nolan, Brian, 1994. "General practitioner utilisation in Ireland: The role of socio-economic factors," Social Science & Medicine, Elsevier, vol. 38(5), pages 711-716, March.
    9. Brimblecombe, Nic & Dorling, Danny & Shaw, Mary, 1999. "Mortality and migration in Britain, first results from the British Household Panel Survey," Social Science & Medicine, Elsevier, vol. 49(7), pages 981-988, October.
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