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Preventive care: underused even when free. Is there something else at work?

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  • Vincenzo Carrieri
  • Marcel Bilger

Abstract

Explaining the rationale of preventive care underuse is a difficult task considering its great benefits for health. Underuse is even more difficult to explain in countries like Italy where preventive care can be obtained for free. In this article we investigate the determinants of prevention underuse with an empirical model based on human capital theory which also includes three factors to which little attention has been paid so far: role played by the General Practitioner (GP), nonmonetary barriers to access and health beliefs. We apply a recursive probit model explaining both recourse to prevention and to the GP which allows us to adequately measure the effect of the latter on the former and to quantitatively compare the determinants of curative and preventive care. We find that the GP plays a minor role in prevention use but that nonmonetary barriers to access and health beliefs are strong determinants of preventive care demand. Finally, we also find support for both Grossman's capital depreciation theory (at younger ages) and Cropper's shorter pay-off period theory (at older ages).

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  • Vincenzo Carrieri & Marcel Bilger, 2013. "Preventive care: underused even when free. Is there something else at work?," Applied Economics, Taylor & Francis Journals, vol. 45(2), pages 239-253, January.
    • Handle: RePEc:taf:applec:45:y:2013:i:2:p:239-253
    DOI: 10.1080/00036846.2011.597729
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    1. Jones, A., 2007. "Applied Econometrics for Health Economists: A Practical Guide," Monographs, Office of Health Economics, number 000262.
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    1. Sarah Hoeck & Johan Van der Heyden & Joanna Geerts & Guido Van Hal, 2013. "Preventive Care Use among the Belgian Elderly Population: Does Socio-Economic Status Matter?," IJERPH, MDPI, vol. 11(1), pages 1-18, December.
    2. Ansgar Wübker, 2014. "Explaining variations in breast cancer screening across European countries," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 15(5), pages 497-514, June.
    3. Panayotis Constantinou & Jonathan Sicsic & Carine Franc, 2017. "Effect of pay-for-performance on cervical cancer screening participation in France," International Journal of Health Economics and Management, Springer, vol. 17(2), pages 181-201, June.
    4. Carrieri, V. & Wuebker, A., 2014. "Does the letter matter (and for everyone)? Quasi-experimental evidence on the effects of home invitation on mammography uptake," Health, Econometrics and Data Group (HEDG) Working Papers 14/11, HEDG, c/o Department of Economics, University of York.
    5. Dickey, H. & Ikenwilo, D. & Norwood, P. & Watson, V. & Zangelidis, A., 2016. "“Doctor my eyes”: A natural experiment on the demand for eye care services," Social Science & Medicine, Elsevier, vol. 150(C), pages 117-127.
    6. Carrieri, Vincenzo & Wuebker, Ansgar, 2013. "Assessing inequalities in preventive care use in Europe," Health Policy, Elsevier, vol. 113(3), pages 247-257.
    7. Alexander Labeit & Frank Peinemann, 2015. "Breast and cervical cancer screening in Great Britain: Dynamic interrelated processes," Health Economics Review, Springer, vol. 5(1), pages 1-17, December.
    8. Jonathan Sicsic & Carine Franc, 2017. "Impact assessment of a pay-for-performance program on breast cancer screening in France using micro data," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 18(5), pages 609-621, June.
    9. repec:zbw:rwirep:0370 is not listed on IDEAS
    10. Dan Kelleher & Samer Kharroubi & Edel Doherty & Gianluca Baio & Ciaran O’Neill, 2022. "Examining the Association between Polish Migrant Status and Health Preferences Using a Novel Application of a Smaller Design EQ-5D-5L Valuation Study," PharmacoEconomics - Open, Springer, vol. 6(3), pages 425-435, May.
    11. INUI Tomohiko & ITO Yukiko & KAWAKAMI Atsushi & MA Xin Xin & NAGASHIMA Masaru & ZHAO Meng, 2017. "Empirical Study on the Utilization and Effects of Health Checkups in Japan," Discussion papers 17082, Research Institute of Economy, Trade and Industry (RIETI).
    12. Maja Matanic Vautmans & Marijana Oreb & Sasa Drezgic, 2023. "Socioeconomic inequality in the use of long-term care for the elderly in Europe," Public Sector Economics, Institute of Public Finance, vol. 47(2), pages 149-176.
    13. Vincenzo Carrieri & Ansgar Wuebker, 2016. "Quasi-Experimental Evidence on the Effects of Health Information on Preventive Behaviour in Europe," Oxford Bulletin of Economics and Statistics, Department of Economics, University of Oxford, vol. 78(6), pages 765-791, December.
    14. Ansgar Wübker, 2012. "Explaining Variations in Breast Cancer Screening Across European Countries," Ruhr Economic Papers 0370, Rheinisch-Westfälisches Institut für Wirtschaftsforschung, Ruhr-Universität Bochum, Universität Dortmund, Universität Duisburg-Essen.
    15. Dugord, Clara & Franc, Carine, 2022. "Trajectories and individual determinants of regular cancer screening use over a long period based on data from the French E3N cohort," Social Science & Medicine, Elsevier, vol. 294(C).
    16. Alexander Michael Labeit & Frank Peinemann, 2017. "Determinants of a GP visit and cervical cancer screening examination in Great Britain," PLOS ONE, Public Library of Science, vol. 12(4), pages 1-14, April.
    17. Vogt, Verena & Siegel, Martin & Sundmacher, Leonie, 2014. "Examining regional variation in the use of cancer screening in Germany," Social Science & Medicine, Elsevier, vol. 110(C), pages 74-80.
    18. Sicsic, Jonathan & Krucien, Nicolas & Franc, Carine, 2016. "What are GPs' preferences for financial and non-financial incentives in cancer screening? Evidence for breast, cervical, and colorectal cancers," Social Science & Medicine, Elsevier, vol. 167(C), pages 116-127.
    19. Carrieri, V. & Wuebker, A., 2012. "Assessing inequalities in preventive care use in Europe: A special case of health-care inequalities?," Health, Econometrics and Data Group (HEDG) Working Papers 12/25, HEDG, c/o Department of Economics, University of York.
    20. Vincenzo Carrieri & Ansgar Wübker, 2012. "Assessing Inequalities in Preventive Care Use in Europe," Ruhr Economic Papers 0371, Rheinisch-Westfälisches Institut für Wirtschaftsforschung, Ruhr-Universität Bochum, Universität Dortmund, Universität Duisburg-Essen.
    21. repec:zbw:rwirep:0371 is not listed on IDEAS

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