IDEAS home Printed from https://ideas.repec.org/a/eso/journl/v37y2006i1p71-90.html
   My bibliography  Save this article

GP Utilisation in Northern Ireland - Exploiting the Gatekeeper Function

Author

Listed:
  • Pat McGregor

    (University of Ulster)

  • Pat McKee

    (University of Ulster)

  • Ciaran O’Neill

    (University of Ulster)

Abstract

Using data from the Northern Ireland Household Panel survey we demonstrate that attendance at outpatients is determined solely by respondent health. This is consistent with the GP acting as a gatekeeper to other services. Attendance thus provides valuable information on illness severity. Splitting the sample into two statistically distinct groups, we estimate ordered probit regressions of GP utilisation with and without sample selection. The results indicate that ignoring outpatient attendance may result in misspecification. Further, if health is more fully measured, age becomes redundant as a determinant of utilisation and service supply, particularly accident and emergency use, is seen as a significant determinant in explaining GP visits.

Suggested Citation

  • Pat McGregor & Pat McKee & Ciaran O’Neill, 2006. "GP Utilisation in Northern Ireland - Exploiting the Gatekeeper Function," The Economic and Social Review, Economic and Social Studies, vol. 37(1), pages 71-90.
    • Handle: RePEc:eso:journl:v:37:y:2006:i:1:p:71-90
    as

    Download full text from publisher

    File URL: http://www.esr.ie/Vol37_1/04_McGregor_article.pdf
    File Function: First version, 2006
    Download Restriction: no
    ---><---

    References listed on IDEAS

    as
    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. Adamson, Joy & Ben-Shlomo, Yoav & Chaturvedi, Nish & Donovan, Jenny, 2003. "Ethnicity, socio-economic position and gender--do they affect reported health--care seeking behaviour?," Social Science & Medicine, Elsevier, vol. 57(5), pages 895-904, September.
    3. Dunlop, Sheryl & Coyte, Peter C. & McIsaac, Warren, 2000. "Socio-economic status and the utilisation of physicians' services: results from the Canadian National Population Health Survey," Social Science & Medicine, Elsevier, vol. 51(1), pages 123-133, July.
    4. 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, July.
    5. David Madden & Anne Nolan & Brian Nolan, 2005. "GP reimbursement and visiting behaviour in Ireland," Health Economics, John Wiley & Sons, Ltd., vol. 14(10), pages 1047-1060, October.
    6. Brimblecombe, Nic & Dorling, Danny & Shaw, Mary, 1999. "Mortality and migration in Britain, first results from the British Household Panel Survey," Social Science & Medicine, Elsevier, vol. 49(7), pages 981-988, October.
    7. Meena Seshamani, 2004. "The Impact of Ageing on Health Care Expenditures: Impending Crisis, or Misguided Concern?," Monograph 000488, Office of Health Economics.
    8. Sutton, Matthew & Carr-Hill, Roy & Gravelle, Hugh & Rice, Nigel, 1999. "Do measures of self-reported morbidity bias the estimation of the determinants of health care utilisation?," Social Science & Medicine, Elsevier, vol. 49(7), pages 867-878, October.
    9. Nolan, Anne & Nolan, Brian, 2003. "A Cross-Sectional Analysis of the Utilisation of GP Services in Ireland: 1987-2001," Papers HRBWP01, Economic and Social Research Institute (ESRI).
    10. Winfried Pohlmeier & Volker Ulrich, 1995. "An Econometric Model of the Two-Part Decisionmaking Process in the Demand for Health Care," Journal of Human Resources, University of Wisconsin Press, vol. 30(2), pages 339-361.
    11. Nolan, Brian, 1994. "General practitioner utilisation in Ireland: The role of socio-economic factors," Social Science & Medicine, Elsevier, vol. 38(5), pages 711-716, March.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. P. McGregor & P. McKee & C. O’Neill, 2008. "The role of non-need factors in individual GP utilisation analysis and their implications for the pursuance of equity: a cross-country comparison," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 9(2), pages 147-156, May.
    2. Edel Doherty & Michelle Queally & Ciaran O’Neill, 2015. "An examination of the relationships between service use and alternative measures of obesity among community-dwelling adults in Ireland," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 16(9), pages 951-956, December.

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. 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.
    2. Nolan, Anne & Nolan, Brian, 2004. "A Panel Data Analysis of The Utilisation of GP Services in Ireland: 1995-2001," Papers HRBWP13, Economic and Social Research Institute (ESRI).
    3. Mujaheed Shaikh & Marisa Miraldo & Anna-Theresa Renner, 2018. "Waiting time at health facilities and social class: Evidence from the Indian caste system," PLOS ONE, Public Library of Science, vol. 13(10), pages 1-16, October.
    4. 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).
    5. McGregor, P. & Nolan, Anne & Nolan, Brian & O'Neill, C., 2006. "A Comparison of GP Visiting in Northern Ireland and the Republic of Ireland," Papers HRBWP22, Economic and Social Research Institute (ESRI).
    6. Nolan, Anne & Nolan, Brian, 2007. "Income, Medical Card Eligibility and Access to GP Services in Ireland," 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).
    7. Teresa Bago d'Uva, 2005. "Latent class models for use of primary care: evidence from a British panel," Health Economics, John Wiley & Sons, Ltd., vol. 14(9), pages 873-892, September.
    8. Erik Schokkaert & Tom Van Ourti & Diana De Graeve & Ann Lecluyse & Carine Van de Voorde, 2010. "Supplemental health insurance and equality of access in Belgium," Health Economics, John Wiley & Sons, Ltd., vol. 19(4), pages 377-395, April.
    9. Tavares, Lara Patrício & Zantomio, Francesca, 2017. "Inequity in healthcare use among older people after 2008: The case of southern European countries," Health Policy, Elsevier, vol. 121(10), pages 1063-1071.
    10. 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.
    11. Jacqueline O'Reilly & Miriam M. Wiley, 2007. "The Public/Private Mix in Irish Acute Public Hospitals: Trends and Implications," Papers WP218, Economic and Social Research Institute (ESRI).
    12. Laudicella, Mauro & Cookson, Richard & Jones, Andrew M. & Rice, Nigel, 2009. "Health care deprivation profiles in the measurement of inequality and inequity: An application to GP fundholding in the English NHS," Journal of Health Economics, Elsevier, vol. 28(6), pages 1048-1061, December.
    13. Callan, Tim & Nolan, Brian, 2004. "Relative Income Poverty: Learning from the Best-Performing Countries," Papers BP2005/2, Economic and Social Research Institute (ESRI).
    14. Bago d'Uva, Teresa & Jones, Andrew M., 2009. "Health care utilisation in Europe: New evidence from the ECHP," Journal of Health Economics, Elsevier, vol. 28(2), pages 265-279, March.
    15. Sato, Azusa, 2012. "Do Inequalities in Health Care Utilization in Developing Countries Change When We Take into Account Traditional Medicines?," World Development, Elsevier, vol. 40(11), pages 2275-2289.
    16. Van der Heyden, J. H. A. & Demarest, S. & Tafforeau, J. & Van Oyen, H., 2003. "Socio-economic differences in the utilisation of health services in Belgium," Health Policy, Elsevier, vol. 65(2), pages 153-165, August.
    17. Garrett, Shane & Mathieu, Catherine & Nolan, Anne & Nolan, Brian & Sterdyniak, Henri, 2004. "Budget Perspectives 2005," Research Series, Economic and Social Research Institute (ESRI), number BMI176 edited by Callan, Tim & Doris, Aedin & McCoy, Daniel, June.
    18. Nolan, Anne & Nolan, Brian, 2004. "Ireland's Health Care System: Some Issues and Challenges," Papers BP2005/3, Economic and Social Research Institute (ESRI).
    19. González Álvarez, M Luz & Barranquero, Antonio Clavero, 2009. "Inequalities in health care utilization in Spain due to double insurance coverage: An Oaxaca-Ransom decomposition," Social Science & Medicine, Elsevier, vol. 69(5), pages 793-801, September.
    20. De Luca, Giuliana & Ponzo, Michela, 2009. "Primary care utilisation and workers’ opportunity costs. Evidence from Italy," MPRA Paper 24201, University Library of Munich, Germany.

    More about this item

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:eso:journl:v:37:y:2006:i:1:p:71-90. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Aedin Doris (email available below). General contact details of provider: https://www.esr.ie .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.