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Co-payments for prescription drugs and the demand for doctor visits - Evidence from a natural experiment

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  • Rainer Winkelmann

    (Department of Economics, University of Zurich, Switzerland)

Abstract

The German health care reform of 1997 provides a natural experiment for evaluating the price sensitivity of demand for physicians' services. As a part of the reform, co-payments for prescription drugs were increased step up to 200%. However, certain groups of people were exempted from the increase, providing a natural control group against which the changed demand for physicians' services of the treated, those subject to increased co-payments, can be assessed. The differences-in-differences estimates indicate that increased co-payments reduced the number of doctor visits by about 10% on an average. Copyright © 2004 John Wiley & Sons, Ltd.

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File URL: http://hdl.handle.net/10.1002/hec.868
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Bibliographic Info

Article provided by John Wiley & Sons, Ltd. in its journal Health Economics.

Volume (Year): 13 (2004)
Issue (Month): 11 ()
Pages: 1081-1089

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Handle: RePEc:wly:hlthec:v:13:y:2004:i:11:p:1081-1089

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Web page: http://www3.interscience.wiley.com/cgi-bin/jhome/5749

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  1. Marianne Bertrand & Esther Duflo & Sendhil Mullainathan, 2004. "How Much Should We Trust Differences-in-Differences Estimates?," The Quarterly Journal of Economics, MIT Press, vol. 119(1), pages 249-275, February.
  2. Gourieroux, Christian & Monfort, Alain & Trognon, Alain, 1984. "Pseudo Maximum Likelihood Methods: Applications to Poisson Models," Econometrica, Econometric Society, vol. 52(3), pages 701-20, May.
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Cited by:
  1. Li, Xin & Guh, Daphne & Lacaille, Diane & Esdaile, John & Anis, Aslam H., 2007. "The impact of cost sharing of prescription drug expenditures on health care utilization by the elderly: Own- and cross-price elasticities," Health Policy, Elsevier, vol. 82(3), pages 340-347, August.
  2. Rainer Winkelmann, 2003. "How Did the German Health Care Reform of 1997 Change the Distribution of the Demand for Health Services?," SOI - Working Papers 0314, Socioeconomic Institute - University of Zurich.
  3. Bremer, Patrick, 2013. "Zuzahlungsbedingter Leistungsverzicht und finanzielle Belastung durch Zuzahlungen bei Personen über 50 in Deutschland," Discussion Papers 25/2013, Witten/Herdecke University, Faculty of Management and Economics.
  4. Andersson, Karolina & Petzold, Max Gustav & Sonesson, Christian & Lonnroth, Knut & Carlsten, Anders, 2006. "Do policy changes in the pharmaceutical reimbursement schedule affect drug expenditures?: Interrupted time series analysis of cost, volume and cost per volume trends in Sweden 1986-2002," Health Policy, Elsevier, vol. 79(2-3), pages 231-243, December.
  5. Jiménez-Rubio, Dolores & Hernández-Quevedo, Cristina, 2010. "Explaining the demand for pharmaceuticals in Spain: Are there differences in drug consumption between foreigners and the Spanish population?," Health Policy, Elsevier, vol. 97(2-3), pages 217-224, October.
  6. Devlin, Rose Anne & Sarma, Sisira & Zhang, Qi, 2011. "The role of supplemental coverage in a universal health insurance system: Some Canadian evidence," Health Policy, Elsevier, vol. 100(1), pages 81-90, April.
  7. Trottmann, Maria & Zweifel, Peter & Beck, Konstantin, 2012. "Supply-side and demand-side cost sharing in deregulated social health insurance: Which is more effective?," Journal of Health Economics, Elsevier, vol. 31(1), pages 231-242.
  8. Pedro Ramos & Álvaro Almeida, 2014. "The Impact of An Increase in User Costs on the Demand For Emergency Services: The Case of Portuguese Hospitals," FEP Working Papers 531, Universidade do Porto, Faculdade de Economia do Porto.
  9. Mas, Nuria & Cirera, Laia & Viñolas, Guillem, 2011. "Los sistemas de copago en Europa, Estados Unidos y Canadá: Implicaciones para el caso español," IESE Research Papers D/939, IESE Business School.
  10. Schmitz, Hendrik, 2013. "Practice budgets and the patient mix of physicians – The effect of a remuneration system reform on health care utilisation," Journal of Health Economics, Elsevier, vol. 32(6), pages 1240-1249.
  11. Helmut Farbmacher; & Joachim Winter, 2012. "Non-linear price schedules, demand for health care and response behavior," Health, Econometrics and Data Group (HEDG) Working Papers 12/15, HEDG, c/o Department of Economics, University of York.
  12. Michel Grignon & Marc Perronnin & John N. Lavis, 2008. "Does free complementary health insurance help the poor to access health care? Evidence from France," Health Economics, John Wiley & Sons, Ltd., vol. 17(2), pages 203-219.

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