Exploring the determinants of endocrinologist visits by patients with diabetes
Abstract Background Diabetes is today a major public health concern in terms of its financial and social burden. Previous studies have revealed that specialist care for patients with diabetes leads to more positive outcomes than care by general practitioners (GPs) alone. The aim of this study was to estimate the determinants of endocrinologist consultation by patients with diabetes. Methods We used a two-part model to explore both the decision to consult and the frequency of consultations. We used claim data collected for 65,633 affiliates of a French social security provider. Patients were aged over 18 and treated for diabetes (types I and II). We controlled for patients’ socioeconomic characteristics, type of diabetes treatment, medical care, and health status. We also controlled for variables, such as the cost of a visit, the distance to the nearest endocrinologist’s office, the density of medical practitioners and the prevalence of diabetes in the area. Results The results show that the parameters associated with the decision to consult an endocrinologist were considerably different from factors associated with the frequency of consultations. A marked positive effect of income on the decision to consult was found, whereas travel time to the office had a negative impact on both the decision to consult and the frequency of consultations. Increasing treatment complexity is associated with a higher probability of consulting an endocrinologist. We found evidence of a significant substitution effect between GPs and endocrinologists. Finally, consultation price is a barrier to seeing an endocrinologist. Conclusion Given that financial barriers were identified in the relatively wealthy population analysed here, it is likely that this may be even more of an obstacle in the general population.
Volume (Year): 17 (2016)
Issue (Month): 9 (December)
|Contact details of provider:|| Web page: http://www.springer.com|
Postal:Universität Duisburg-Essen, Fakultät für Wirtschaftswissenschaften, Lehrstuhl für Volkswirtschaftslehre, insbesondere Quantitative Wirtschaftspolitik, Weststadttürme Berliner Platz 6-8, 45127 Essen
Phone: +49 201 183-4622
Fax: +49 201 183-2879
Web page: https://www.dggoe.de/
More information through EDIRC
|Order Information:||Web: http://www.springer.com/medicine/health+informatics/journal/10198/PS2|
References listed on IDEAS
Please report citation or reference errors to , or , if you are the registered author of the cited work, log in to your RePEc Author Service profile, click on "citations" and make appropriate adjustments.:
- Sergi Jiménez-Martín & José Labeaga & Maite Martínez-Granado, 2004.
"An empirical analysis of the demand for physician services across the European Union,"
The European Journal of Health Economics,
Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 5(2), pages 150-165, May.
- 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.
- Ulf- G. Gerdtham, 1997. "Equity in Health Care Utilization: Further Tests Based on Hurdle Models and Swedish Micro Data," Health Economics, John Wiley & Sons, Ltd., vol. 6(3), pages 303-319.
- Gerdtham, Ulf-G., 1996. "Equity in Health Care Utilisation: Further Tests Based on Hurdle models and Swedish Micro Data," SSE/EFI Working Paper Series in Economics and Finance 116, Stockholm School of Economics.
- Mullahy, John, 1998. "Much ado about two: reconsidering retransformation and the two-part model in health econometrics," Journal of Health Economics, Elsevier, vol. 17(3), pages 247-281, June.
- John Mullahy, 1998. "Much Ado About Two: Reconsidering Retransformation and the Two-Part Model in Health Economics," NBER Technical Working Papers 0228, National Bureau of Economic Research, Inc.
- Éric Delattre & Brigitte Dormont, 2000. "Induction de la demande de soins par les médecins libéraux français. Étude micro-économétrique sur données de panel," Économie et Prévision, Programme National Persée, vol. 142(1), pages 137-161.
- E Delattre & B. Dormont, 1999. "Induction de la demande de soins par les médecins libéraux français. Etude microéconométrique sur données de panel," THEMA Working Papers 99-21, THEMA (THéorie Economique, Modélisation et Applications), Université de Cergy-Pontoise.
- Heckman, James, 2013. "Sample selection bias as a specification error," Applied Econometrics, Publishing House "SINERGIA PRESS", vol. 31(3), pages 129-137.
- Heckman, James J, 1979. "Sample Selection Bias as a Specification Error," Econometrica, Econometric Society, vol. 47(1), pages 153-161, January.
- Madden, David, 2008. "Sample selection versus two-part models revisited: The case of female smoking and drinking," Journal of Health Economics, Elsevier, vol. 27(2), pages 300-307, March.
- David (David Patrick) Madden, 2006. "Sample selection versus two-part models revisited : the case of female smoking and drinking," Working Papers 200604, School of Economics, University College Dublin.
- David Madden, 2006. "Sample Selection Versus Two-Part Models Revisited: the Case of Female Smoking and Drinking," Health, Econometrics and Data Group (HEDG) Working Papers 06/12, HEDG, c/o Department of Economics, University of York.
- Madden, David, 2006. "Sample Selection Versus Two-Part Models Revisited: The Case of Female Smoking and Drinking," Papers HRBWP23, Economic and Social Research Institute (ESRI).
- 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.
- 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 223-255, March-Apr.
- Gächter, Martin & Schwazer, Peter & Theurl, Engelbert & Winner, Hannes, 2012. "Physician density in a two-tiered health care system," Health Policy, Elsevier, vol. 106(3), pages 257-268.
- Gächter, Martin & Schwazer, Peter & Theurl, Engelbert & Winner, Hannes, 2011. "Physician Density in a Two-Tiered Health Care System," Working Papers in Economics 2011-5, University of Salzburg.
- Iezzi, Elisa & Lippi Bruni, Matteo & Ugolini, Cristina, 2014. "The role of GP's compensation schemes in diabetes care: Evidence from panel data," Journal of Health Economics, Elsevier, vol. 34(C), pages 104-120.
- E. Iezzi & M. Lippi Bruni & C. Ugolini, 2011. "The role of GP’s compensation schemes in diabetes care: evidence from panel data," Working Papers wp766, Dipartimento Scienze Economiche, Universita' di Bologna.
- Wedig, Gerard J., 1988. "Health status and the demand for health : Results on price elasticities," Journal of Health Economics, Elsevier, vol. 7(2), pages 151-163, June.
- Hung, Jung-Hua & Chang, Li, 2008. "Has cost containment after the National Health Insurance system been successful: Determinants of Taiwan hospital costs," Health Policy, Elsevier, vol. 85(3), pages 321-335, March.
- Robert Kaestner, 2013. "The Grossman model after 40 years: a reply to Peter Zweifel," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 14(2), pages 357-360, April. Full references (including those not matched with items on IDEAS)
When requesting a correction, please mention this item's handle: RePEc:spr:eujhec:v:17:y:2016:i:9:d:10.1007_s10198-016-0794-1. See general information about how to correct material in RePEc.
For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: (Sonal Shukla)or (Rebekah McClure)
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 references are entirely missing, you can add them using this form.
If the full references list an item that is present in RePEc, but the system did not link 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 profile, as there may be some citations waiting for confirmation.
Please note that corrections may take a couple of weeks to filter through the various RePEc services.