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Copayments, gatekeeping, and the utilization of outpatient public and private care at age 50 and above in Europe

  • Bíró, Anikó

I analyze the relationship between health care institutions and the utilization of outpatient services by individuals aged 50 and above. I use cross-sectional micro data from thirteen European countries. I focus on the out-of-pocket costs of health care utilization, the gatekeeper role of general practitioners, and how these institutional settings are related to public and private care utilization. I find that copayments are related negatively to the probability of visiting a general practitioner among those in good health condition. I estimate the utilization of private specialist care to be higher in countries where copayments are required for public specialist care, and where the general practitioners have gatekeeper role. These estimated associations with private specialist care utilization are relatively large in magnitude, and are driven by individuals in the top income quartile.

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Article provided by Elsevier in its journal Health Policy.

Volume (Year): 111 (2013)
Issue (Month): 1 ()
Pages: 24-33

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Handle: RePEc:eee:hepoli:v:111:y:2013:i:1:p:24-33
Contact details of provider: Web page: http://www.elsevier.com/locate/healthpol

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  1. Sergi Jiménez-Martín & José M. Labeaga & Maite Martínez-Granado, 2003. "An Empirical Analysis of the Demand for Physician Services Across the European Union," Economic Working Papers at Centro de Estudios Andaluces E2003/45, Centro de Estudios Andaluces.
  2. Kristian Bolin & Anna Lindgren & Björn Lindgren & Petter Lundborg, 2009. "Utilisation of physician services in the 50+ population: the relative importance of individual versus institutional factors in 10 European countries," International Journal of Health Care Finance and Economics, Springer, vol. 9(1), pages 83-112, March.
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  6. Hitiris, Theo & Posnett, John, 1992. "The determinants and effects of health expenditure in developed countries," Journal of Health Economics, Elsevier, vol. 11(2), pages 173-181, August.
  7. 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.
  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.
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