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Preventive care: underused even when free. A tale from Italy

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  • Vicenzo Carrieri
  • Marcel Bilger

Abstract

Despite being strongly recommended for health, preventive care is significantly underused even in countries like Italy where it can be obtained for free. We analyze the determinants of pap test and mammography utilization with an empirical model based on human capital theory. One original feature is the simultaneous inclusion of: health beliefs, general practitioner and non-monetary barriers to access. Using a recursive probit model explaining both recourse to prevention and physician visit, we find evidence to support both Grossman's capital depreciation theory (at younger ages) and Cropper's shorter pay-off period theory (at older ages). We also show that health beliefs play a key role and that the general practitioner hardly affects the decision to undergo preventive treatments. Finally, prevention supply does not appear to be a factor and there is considerable geographical heterogeneity.

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Bibliographic Info

Paper provided by Institut d'Economie et Econométrie, Université de Genève in its series Research Papers by the Institute of Economics and Econometrics, Geneva School of Economics and Management, University of Geneva with number 2009.02.

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Length: 22 pages
Date of creation: Feb 2009
Date of revision:
Handle: RePEc:gen:geneem:2009.02

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Related research

Keywords: preventive care; human capital model; health beliefs; general practitioner; recursive probit model;

References

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  1. Scott, Anthony, 2000. "Economics of general practice," Handbook of Health Economics, in: A. J. Culyer & J. P. Newhouse (ed.), Handbook of Health Economics, edition 1, volume 1, chapter 22, pages 1175-1200 Elsevier.
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  3. Muurinen, Jaana-Marja, 1982. "Demand for health: A generalised Grossman model," Journal of Health Economics, Elsevier, vol. 1(1), pages 5-28, May.
  4. Clarke, Philip M., 1998. "Cost-benefit analysis and mammographic screening: a travel cost approach," Journal of Health Economics, Elsevier, vol. 17(6), pages 767-787, December.
  5. Lairson, David R. & Chan, Wenyaw & Newmark, Georgina R., 2005. "Determinants of the demand for breast cancer screening among women veterans in the United States," Social Science & Medicine, Elsevier, vol. 61(7), pages 1608-1617, October.
  6. Jenkins, Christopher N. H. & Le, Thao & McPhee, Stephen J. & Stewart, Susan & Ha, Ngoc The, 1996. "Health care access and preventive care among Vietnamese immigrants: Do traditional beliefs and practices pose barriers?," Social Science & Medicine, Elsevier, vol. 43(7), pages 1049-1056, October.
  7. Dardanoni, Valentino & Wagstaff, Adam, 1990. "Uncertainty and the demand for medical care," Journal of Health Economics, Elsevier, vol. 9(1), pages 23-38, June.
  8. Manning, Willard G, et al, 1987. "Health Insurance and the Demand for Medical Care: Evidence from a Randomized Experiment," American Economic Review, American Economic Association, vol. 77(3), pages 251-77, June.
  9. Cook, Philip J & Graham, Daniel A, 1977. "The Demand for Insurance and Protection: The Case of Irreplaceable Commodities," The Quarterly Journal of Economics, MIT Press, vol. 91(1), pages 143-56, February.
  10. Viscusi, W Kip, 1990. "Do Smokers Underestimate Risks?," Journal of Political Economy, University of Chicago Press, vol. 98(6), pages 1253-69, December.
  11. Acton, Jan Paul, 1975. "Nonmonetary Factors in the Demand for Medical Services: Some Empirical Evidence," Journal of Political Economy, University of Chicago Press, vol. 83(3), pages 595-614, June.
  12. Cropper, M L, 1977. "Health, Investment in Health, and Occupational Choice," Journal of Political Economy, University of Chicago Press, vol. 85(6), pages 1273-94, December.
  13. Grossman, Michael, 1972. "On the Concept of Health Capital and the Demand for Health," Journal of Political Economy, University of Chicago Press, vol. 80(2), pages 223-55, March-Apr.
  14. Laura Greene Knapp & Terry Seaks, 1998. "A Hausman test for a dummy variable in probit," Applied Economics Letters, Taylor & Francis Journals, vol. 5(5), pages 321-323.
  15. Ehrlich, Isaac & Chuma, Hiroyuki, 1990. "A Model of the Demand for Longevity and the Value of Life Extension," Journal of Political Economy, University of Chicago Press, vol. 98(4), pages 761-82, August.
  16. Kenkel, D., 1988. "The Demand For Preventive Medical Care," Papers 3-88-4, Pennsylvania State - Department of Economics.
  17. Dardanoni, Valentino & Wagstaff, Adam, 1987. "Uncertainty, inequalities in health and the demand for health," Journal of Health Economics, Elsevier, vol. 6(4), pages 283-290, December.
  18. Pauly, Mark V, 1986. "Taxation, Health Insurance, and Market Failure in the Medical Economy," Journal of Economic Literature, American Economic Association, vol. 24(2), pages 629-75, June.
  19. Catharina Hjortsberg, 2003. "Why do the sick not utilise health care? The case of Zambia," Health Economics, John Wiley & Sons, Ltd., vol. 12(9), pages 755-770.
  20. Selden, Thomas M., 1993. "Uncertainty and health care spending by the poor: The health capital model revisited," Journal of Health Economics, Elsevier, vol. 12(1), pages 109-115, April.
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