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Impact of health care system on socioeconomic inequalities in doctor use

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Author Info

  • Zeynep Or

    ()
    (IRDES institut for research and information in health economics)

  • Florence Jusot

    ()
    (IRDES institut for research and information in health economics)

  • Engin Yilmaz

    ()
    (IRDES institut for research and information in health economics)

Abstract

This study examines the impact of health system characteristics on social inequities in health care use in Europe, using data from national surveys in 13 European countries. Multilevel logistic regression models are estimated to separate the individual level determinants of generalist and specialist use from the health system level and country specific factors. The results suggest that beyond the division between public and private funding and cost-sharing arrangements in health system, the role given to the general practitioners and/or the organization of the primary care might be essential for reducing social inequities in health care utilisation.

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File URL: http://www.irdes.fr/EspaceAnglais/Publications/WorkingPapers/DT17ImpactHealthCareSystSocioeconomicInequalities.pdf
File Function: First version, 2008
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Bibliographic Info

Paper provided by IRDES institut for research and information in health economics in its series Working Papers with number DT17.

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Length: 23 pages
Date of creation: Sep 2008
Date of revision: Sep 2008
Handle: RePEc:irh:wpaper:dt17

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Keywords: Equity; Health system; Doctor utilisation; Multilevel; International;

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References

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  1. van Doorslaer, Eddy & Wagstaff, Adam & van der Burg, Hattem & Christiansen, Terkel & De Graeve, Diana & Duchesne, Inge & Gerdtham, Ulf-G & Gerfin, Michael & Geurts, Jose & Gross, Lorna, 2000. "Equity in the delivery of health care in Europe and the US," Journal of Health Economics, Elsevier, vol. 19(5), pages 553-583, September.
  2. Bongers, Inge M. B. & Van Der Meer, Joost B. W. & Van Den Bos, Johannes & Mackenbach, Johan P., 1997. "Socio-economic differences in general practitioner and outpatient specialist care in the Netherlands: A matter of health insurance?," Social Science & Medicine, Elsevier, vol. 44(8), pages 1161-1168, April.
  3. Or, Zeynep & Wang, Jia & Jamison, Dean, 2005. "International differences in the impact of doctors on health: a multilevel analysis of OECD countries," Journal of Health Economics, Elsevier, vol. 24(3), pages 531-560, May.
  4. Yilmaz, Engin & Jusot, Florence & Or, Zeynep, 2008. "Impact of health care system on socioeconomic inequalities in doctor use," Economics Papers from University Paris Dauphine 123456789/7006, Paris Dauphine University.
  5. 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.
  6. Alberts, Jantina F. & Sanderman, Robbert & Gerstenbluth, Izzy & van den Heuvel, Wim J. A., 1998. "Sociocultural variations in help-seeking behavior for everyday symptoms and chronic disorders," Health Policy, Elsevier, vol. 44(1), pages 57-72, April.
  7. Florence Jusot, 2004. "Mortalité et inégalités de revenu en France," DELTA Working Papers 2004-32, DELTA (Ecole normale supérieure).
  8. 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.
  9. Grossman, Michael, 2000. "The human capital model," Handbook of Health Economics, in: A. J. Culyer & J. P. Newhouse (ed.), Handbook of Health Economics, edition 1, volume 1, chapter 7, pages 347-408 Elsevier.
  10. Alberts, Jantina F. & Sanderman, Robbert & Eimers, J. Marietta & Van Den Heuvel, Wim J. A., 1997. "Socioeconomic inequity in health care: A study of services utilization in Curaçao," Social Science & Medicine, Elsevier, vol. 45(2), pages 213-220, July.
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Citations

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Cited by:
  1. Ana Poças & Elias Soukiazis, 2013. "Are health factors important for regional growth and convergence? An empirical analysis for the Portuguese districts," International Journal of Public Policy, Inderscience Enterprises Ltd, vol. 9(1/2), pages 44-64.
  2. Zeynep Or & Chantal Cases & Melanie Lisac & Karsten Vrangbaek & Ulrika Winblad & Gwyn Bevan, 2009. "Are Health Problems Systemic? Politics of Access and Choice under Beveridge and Bismarck Systems," Working Papers DT27, IRDES institut for research and information in health economics, revised Sep 2009.
  3. Zeynep Or & Florence Jusot & Engin Yilmaz, 2008. "Impact of health care system on socioeconomic inequalities in doctor use," Working Papers DT17, IRDES institut for research and information in health economics, revised Sep 2008.
  4. Thierry Debrand & Christine Sorasith, 2010. "Out-of-Pocket Maximum Rules under a Compulsatory Health Care Insurance Scheme: A Choice between Equality and Equity," Working Papers DT34, IRDES institut for research and information in health economics, revised Nov 2010.
  5. Groenewegen, Peter P. & Dourgnon, Paul & Greß, Stefan & Jurgutis, Arnoldas & Willems, Sara, 2013. "Strengthening weak primary care systems: Steps towards stronger primary care in selected Western and Eastern European countries," Health Policy, Elsevier, vol. 113(1), pages 170-179.

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