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The effect of differential eligibility for free GP services on GP utilisation in Ireland

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  • Nolan, Anne
  • Smith, Samantha

Abstract

Internationally, there is extensive empirical evidence that a strong primary care-led health system is associated with improved health outcomes, increased quality of care, decreased health inequalities and lower overall health-care costs. Within primary care, factors influencing access to, and utilisation of, general practitioner (GP) services have been widely examined and this paper focuses on the role of user financial incentives. In particular, user charges for health care have been observed to deter health-care utilisation. Relative to other countries, the Irish health-care system is unusual in that the majority of the population are required to pay out-of-pocket for GP care. However, in 2005 the Irish government extended eligibility for free GP care to a further small subset of the population. Using micro-data from a nationally representative survey of the population in 2007, this paper analyses the impact of differential coverage of free GP services on GP utilisation in Ireland. Results from multivariate regression analysis indicate that GP utilisation is significantly more likely in the context of free GP care, controlling for a range of demographic, socio-economic and health factors. Interpretation of the results for the new category of coverage is complicated by possible pent-up demand and selection effects.

Suggested Citation

  • Nolan, Anne & Smith, Samantha, 2012. "The effect of differential eligibility for free GP services on GP utilisation in Ireland," Social Science & Medicine, Elsevier, vol. 74(10), pages 1644-1651.
    • Handle: RePEc:eee:socmed:v:74:y:2012:i:10:p:1644-1651
    DOI: 10.1016/j.socscimed.2012.02.007
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    References listed on IDEAS

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    1. Starfield, Barbara & Shi, Leiyu, 2002. "Policy relevant determinants of health: an international perspective," Health Policy, Elsevier, vol. 60(3), pages 201-218, June.
    2. Layte, Richard & Nolan, Anne & McGee, Hannah & O'Hanlon, Ann, 2009. "Do consultation charges deter general practitioner use among older people? A natural experiment," Social Science & Medicine, Elsevier, vol. 68(8), pages 1432-1438, April.
    3. Mark Stabile, 2001. "Private insurance subsidies and public health care markets: evidence from Canada," Canadian Journal of Economics, Canadian Economics Association, vol. 34(4), pages 921-942, November.
    4. Nolan, Anne, 2007. "The Economics of GP Utilisation," 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).
    5. Sara Allin & Jeremiah Hurley, 2009. "Inequity in publicly funded physician care: what is the role of private prescription drug insurance?," Health Economics, John Wiley & Sons, Ltd., vol. 18(10), pages 1218-1232, October.
    6. Samantha Smith, 2010. "The Irish ‘health basket’: a basket case?," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 11(3), pages 343-350, June.
    7. Deininger, Klaus & Mpuga, Paul, 2004. "Economic and Welfare Effects of the Abolition of Health User Fees : Evidence from Uganda," Policy Research Working Paper Series 3276, The World Bank.
    8. Cumming, Jacqueline & Mays, Nicholas, 2011. "New Zealand’s Primary Health Care Strategy: early effects of the new financing and payment system for general practice and future challenges," Health Economics, Policy and Law, Cambridge University Press, vol. 6(1), pages 1-21, January.
    9. Brick, Aoife & Nolan, Anne & O'Reilly, Jacqueline & Smith, Samantha, 2010. "Resource Allocation, Financing and Sustainability in the Health Sector," Papers RB2010/3/1, Economic and Social Research Institute (ESRI).
    10. Shi, L. & Macinko, J. & Starfield, B. & Politzer, R. & Wulu, J. & Xu, J., 2005. "Primary care, social inequalities, and all-cause, heart disease, and cancer mortality in US counties, 1990," American Journal of Public Health, American Public Health Association, vol. 95(4), pages 674-680.
    11. Nolan, Anne & Nolan, Brian, 2007. "The Utilisation of GP Services," 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).
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    1. Richard Layte & Anne Nolan, 2015. "Eligibility for free GP care and the utilisation of GP services by children in Ireland," International Journal of Health Economics and Management, Springer, vol. 15(1), pages 3-27, March.
    2. Cullinan, John & Cawley, John, 2017. "Parental misclassification of child overweight/obese status: The role of parental education and parental weight status," Economics & Human Biology, Elsevier, vol. 24(C), pages 92-103.
    3. Pymont, Carly & McNamee, Paul & Butterworth, Peter, 2018. "Out-of-pocket costs, primary care frequent attendance and sample selection: Estimates from a longitudinal cohort design," Health Policy, Elsevier, vol. 122(6), pages 652-659.
    4. Jatrana, Santosh & Crampton, Peter, 2021. "Do financial barriers to access to primary health care increase the risk of poor health? Longitudinal evidence from New Zealand," Social Science & Medicine, Elsevier, vol. 288(C).
    5. Richard Layte & Anne Nolan, 2015. "Income-related inequity in the use of GP services by children: a comparison of Ireland and Scotland," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 16(5), pages 489-506, June.
    6. Layte, Richard & Nolan, Anne, 2013. "Income-Related Inequity in the Use of GP Services: A Comparison of Ireland and Scotland," Papers WP454, Economic and Social Research Institute (ESRI).
    7. Thomson, Michael, 2019. "Who had access to doctors before and after new universal capitated subsidies in New Zealand?," Health Policy, Elsevier, vol. 123(8), pages 756-764.
    8. Hudson, Eibhlin & Nolan, Anne, 2015. "Public healthcare eligibility and the utilisation of GP services by older people in Ireland," The Journal of the Economics of Ageing, Elsevier, vol. 6(C), pages 24-43.
    9. Smith, Samantha & Walsh, Brendan & Wren, Maev-Ann & Barron, Steve & Morgenroth, Edgar & Eighan, James & Lyons, Seán, 2019. "Geographic profile of healthcare needs and non-acute healthcare supply in Ireland," Research Series, Economic and Social Research Institute (ESRI), number RS90.
    10. Keegan, Conor & Brick, Aoife & García-Rodríguez, Abián & Hill, Leonie, 2022. "Projections of workforce requirements for public acute hospitals in Ireland, 2019–2035: a regional analysis based on the hippocrates model," Research Series, Economic and Social Research Institute (ESRI), number RS147.
    11. Humes, Harry & Barrett, Michelle & Walsh, Brendan, 2024. "Effects of new residential developments on local healthcare demand and workforce: evidence from primary and acute public hospital care in Ireland," Research Series, Economic and Social Research Institute (ESRI), number RS181.

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