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A Cross-Sectional Analysis of the Utilisation of GP Services in Ireland: 1987-2001

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  • Nolan, Anne

    (Economic and Social Research Institute (ESRI))

  • Nolan, Brian

    (Economic and Social Research Institute (ESRI))

Abstract

This paper examines the determinants of general practitioner (GP) utilisation patterns in Ireland over the period 1987-2001. Using three different micro-data sets, the influence of socio-economic factors as well as health status variables on the demand for GP visits is analysed. A particular focus of this paper is an examination of the impact of economic incentives as represented by medical card eligibility. While medical cardholders are entitled to free GP consultations, nonmedical cardholders must pay for each visit. In addition, it is important to analyse the impact of the 1989 change in the reimbursement system for GPs with medical cardholder patients from fee for service to capitation. A variety of cross-sectional econometric methodologies are considered with the two-step hurdle negative binomial model found to be the most appropriate. The empirical results confirm the results of earlier studies about the effects of socio-economic characteristics such as age, sex and income on GP utilisation patterns and also confirm the highly significant effects of health status. While medical card eligibility is consistently positive and significant across the years of our analysis (1987, 1995, 2000, 2001), there is no evidence to show that this effect diminished in importance between 1987 and 1995.

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Bibliographic Info

Paper provided by Economic and Social Research Institute (ESRI) in its series Papers with number HRBWP01.

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Length: 48 pages
Date of creation: Nov 2003
Date of revision:
Handle: RePEc:esr:wpaper:hrb01

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Keywords: hrb;

References

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  1. Thomas C. Buchmueller & Agnès Couffinhal & Michel Grignon & Marc Perronnin, 2004. "Access to physician services: does supplemental insurance matter? Evidence from France," Health Economics, John Wiley & Sons, Ltd., vol. 13(7), pages 669-687.
  2. Chiappori, Pierre-Andre & Durand, Franck & Geoffard, Pierre-Yves, 1998. "Moral hazard and the demand for physician services: First lessons from a French natural experiment," European Economic Review, Elsevier, vol. 42(3-5), pages 499-511, May.
  3. Joao M.C. Santos Silva & Frank Windmeijer, 1999. "Two-part multiple spell models for health care demand," IFS Working Papers W99/02, Institute for Fiscal Studies.
  4. Hurd, Michael D. & McGarry, Kathleen, 1997. "Medical insurance and the use of health care services by the elderly," Journal of Health Economics, Elsevier, vol. 16(2), pages 129-154, April.
  5. 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.
  6. Martin Schellhorn, 2001. "The effect of variable health insurance deductibles on the demand for physician visits," Health Economics, John Wiley & Sons, Ltd., vol. 10(5), pages 441-456.
  7. Cameron, A C & P. K. Trivedi & Frank Milne & J. Piggott, 1988. "A Microeconometric Model of the Demand for Health Care and Health Insurance in Australia," Review of Economic Studies, Wiley Blackwell, vol. 55(1), pages 85-106, January.
  8. Alberto HOLLY & Lucien GARDIOL & Gianfranco DOMENIGHETTI & Brigitte BISIG, 1998. "An Econometric Model of Health Care Utilization and Health Insurance in Switzerland," Cahiers de Recherches Economiques du Département d'Econométrie et d'Economie politique (DEEP) 9803, Université de Lausanne, Faculté des HEC, DEEP.
  9. Sergi Jiménez-Mart�n & José M. Labeaga & Maite Mart�nez-Granado, 2002. "Latent class versus two-part models in the demand for physician services across the European Union," Health Economics, John Wiley & Sons, Ltd., vol. 11(4), pages 301-321.
  10. �ngel Marcos Vera-Hernández, 1999. "Duplicate coverage and demand for health care. The case of Catalonia," Health Economics, John Wiley & Sons, Ltd., vol. 8(7), pages 579-598.
  11. Colm Harmon & Brian Nolan, 2001. "Health insurance and health services utilization in Ireland," Health Economics, John Wiley & Sons, Ltd., vol. 10(2), pages 135-145.
  12. Nolan, Brian, 1993. "Economic incentives, health status and health services utilisation," Journal of Health Economics, Elsevier, vol. 12(2), pages 151-169, July.
  13. Nolan, Brian, 1991. "The Utilisation and Financing of Health Services in Ireland," Research Series, Economic and Social Research Institute (ESRI), number GRS155.
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Citations

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Cited by:
  1. Pat McGregor & Pat McKee & Ciaran O’Neill, 2006. "GP Utilisation in Northern Ireland - Exploiting the Gatekeeper Function," The Economic and Social Review, Economic and Social Studies, vol. 37(1), pages 71-90.
  2. Callan, Tim & Nolan, Brian, 2004. "Relative Income Poverty: Learning from the Best-Performing Countries," Papers BP2005/2, Economic and Social Research Institute (ESRI).
  3. Jacqueline O'Reilly & Miriam M. Wiley, 2007. "The Public/Private Mix in Irish Acute Public Hospitals: Trends and Implications," Papers WP218, Economic and Social Research Institute (ESRI).
  4. Smith, Samantha, 2007. "Emergency Department Utilisation in Four Irish Teaching Hospitals," Papers HRBWP26, Economic and Social Research Institute (ESRI).
  5. Garrett, Shane & Mathieu, Catherine & Nolan, Anne & Nolan, Brian & Sterdyniak, Henri, 2004. "Budget Perspectives 2005," Research Series, Economic and Social Research Institute (ESRI), number BMI176 edited by Callan, Tim & Doris, Aedin & McCoy, Daniel.
  6. Nolan, Anne & Nolan, Brian, 2007. "Income, Medical Card Eligibility and Access to GP Services in Ireland," Book Chapters, in: Nolan, Brian (ed.), The Provision and Use of Health Services, Health Inequalities and Health and Social Gain Economic and Social Research Institute (ESRI).
  7. McGregor, P. & Nolan, Anne & Nolan, Brian & O'Neill, C., 2006. "A Comparison of GP Visiting in Northern Ireland and the Republic of Ireland," Papers HRBWP22, Economic and Social Research Institute (ESRI).
  8. Nolan, Anne & Nolan, Brian, 2004. "Ireland's Health Care System: Some Issues and Challenges," Papers BP2005/3, Economic and Social Research Institute (ESRI).
  9. Nolan, Anne & Nolan, Brian, 2004. "A Panel Data Analysis of The Utilisation of GP Services in Ireland: 1995-2001," Papers HRBWP13, Economic and Social Research Institute (ESRI).

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