GP reimbursement and visiting behaviour in Ireland
In Ireland, approximately 30% of the population receive free GP services ('medical card patients') while the remainder ('private patients') must pay for each visit. In 1989, the manner in which GPs were reimbursed by the State for their medical card patients was changed from fee-for-service to capitation while private patients continued to pay on a fee-for-service basis. Concerns about supplier-induced demand were in part responsible for this policy change. The purpose of this paper is to examine the extent to which the utilisation of GP services is influenced by the reimbursement system facing GPs, by comparing visiting rates for the two groups before and after this change. Using a difference-in-differences approach on pooled micro-data from 1987, 1995 and 2000, we find that medical card eligibility has a consistently positive and significant effect on the utilisation of GP services. However, the differential in visiting rates between medical card patients and others did not narrow between 1987 and 1995 or 2000, as might have been anticipated if supplier-induced demand played a major role prior to the change in reimbursement system. Copyright © 2005 John Wiley & Sons, Ltd.
Volume (Year): 14 (2005)
Issue (Month): 10 ()
|Contact details of provider:|| Web page: http://www3.interscience.wiley.com/cgi-bin/jhome/5749|
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.:
- Mark Dusheiko & Hugh Gravelle & Rowena Jacobs & Peter Smith, 2003.
"The Effects of Budgets on Doctors Behaviour: Evidence from a Natural Experiment,"
The Centre for Market and Public Organisation
03/064, Department of Economics, University of Bristol, UK.
- Mark Dusheiko & Hugh Gravelle & Rowena Jacobs & Peter C Smith, . "The Effect of Budgets on Doctor Behaviour: Evidence From A Natural Experiment," Discussion Papers 03/04, Department of Economics, University of York.
- Ulf-G. Gerdtham & Pravin K. Trivedi, 2001.
"Equity in Swedish health care reconsidered: new results based on the finite mixture model,"
John Wiley & Sons, Ltd., vol. 10(6), pages 565-572.
- Gerdtham, Ulf-G. & Trivedi, Pravin K., 2000. "Equity in Swedish Health Care Reconsidered: New Results based on the Finite Mixture Model," SSE/EFI Working Paper Series in Economics and Finance 365, Stockholm School of Economics.
- Cockx, Bart & Brasseur, Carine, 2003.
"The demand for physician services: Evidence from a natural experiment,"
Journal of Health Economics,
Elsevier, vol. 22(6), pages 881-913, November.
- Bart COCKX & Carine BRASSEUR, 2001. "The Demand for Physician Services. Evidence from a Natural Experiment," Discussion Papers (IRES - Institut de Recherches Economiques et Sociales) 2001027, Université catholique de Louvain, Institut de Recherches Economiques et Sociales (IRES).
- J Durkan; & C Harmon; & J Hughes, 1996. "Health Services Utilisation in the UK. An Empirical Analysis Using Microdata," Economics, Finance and Accounting Department Working Paper Series n650796, Department of Economics, Finance and Accounting, National University of Ireland - Maynooth.
- Tussing, A. Dale, 1985. "Irish Medical Care Resources: An Economic Analysis," Research Series, Economic and Social Research Institute (ESRI), number GRS126.
- Russell, Helen & Layte, Richard & Maitre, Bertrand & O'Connell, Philip J. & Whelan, Christopher T., 2004. "Work-Poor Households: The Welfare Implications of Changing Household Employment Patterns," Research Series, Economic and Social Research Institute (ESRI), number PRS52.
- Cromwell, Jerry & Mitchell, Janet B., 1986. "Physician-induced demand for surgery," Journal of Health Economics, Elsevier, vol. 5(4), pages 293-313, December.
- Grytten, Jostein & Carlsen, Fredrik & Sorensen, Rune, 1995. "Supplier inducement in a public health care system," Journal of Health Economics, Elsevier, vol. 14(2), pages 207-229, June.
- Grytten, Jostein & Sorensen, Rune, 2001. "Type of contract and supplier-induced demand for primary physicians in Norway," Journal of Health Economics, Elsevier, vol. 20(3), pages 379-393, May.
- Nolan, Brian, 1993. "Economic incentives, health status and health services utilisation," Journal of Health Economics, Elsevier, vol. 12(2), pages 151-169, July.
- Croxson, B. & Propper, C. & Perkins, A., 2001. "Do doctors respond to financial incentives? UK family doctors and the GP fundholder scheme," Journal of Public Economics, Elsevier, vol. 79(2), pages 375-398, February.
- Chiappori, Pierre-Andre & Durand, Franck & Geoffard, Pierre-Yves, 1998.
"Moral hazard and the demand for physician services: First lessons from a French natural experiment,"
European Economic Review,
Elsevier, vol. 42(3-5), pages 499-511, May.
- Chiappori, P.A. & Durand, F. & Geoffard, P.Y., 1998. "Moral Hazard and the Demand for Physician Services: First Lessons from a French Natural Experiment," DELTA Working Papers 98-05, DELTA (Ecole normale supérieure).
- Hurd, Michael D. & McGarry, Kathleen, 1997. "Medical insurance and the use of health care services by the elderly," Journal of Health Economics, Elsevier, vol. 16(2), pages 129-154, April.
- Thomas C. Buchmueller & Agnès Couffinhal & Michel Grignon & Marc Perronin, 2002.
"Access to Physician Services: Does Supplemental Insurance Matter? Evidence from France,"
NBER Working Papers
9238, National Bureau of Economic Research, Inc.
- Thomas C. Buchmueller & Agnès Couffinhal & Michel Grignon & Marc Perronnin, 2004. "Access to physician services: does supplemental insurance matter? Evidence from France," Health Economics, John Wiley & Sons, Ltd., vol. 13(7), pages 669-687.
- Joao M.C. Santos Silva & Frank Windmeijer, 1999.
"Two-part multiple spell models for health care demand,"
IFS Working Papers
W99/02, Institute for Fiscal Studies.
- Santos Silva, Joao M. C. & Windmeijer, Frank, 2001. "Two-part multiple spell models for health care demand," Journal of Econometrics, Elsevier, vol. 104(1), pages 67-89, August.
- Sergi Jiménez-Mart�n & José M. Labeaga & Maite Mart�nez-Granado, 2002. "Latent class versus two-part models in the demand for physician services across the European Union," Health Economics, John Wiley & Sons, Ltd., vol. 11(4), pages 301-321.
- 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.
- Fredrik Carlsen & Jostein Grytten, 1998. "More physicians: improved availability or induced demand?," Health Economics, John Wiley & Sons, Ltd., vol. 7(6), pages 495-508.
- Callan, Tim & Nolan, Brian & Whelan, Brendan J. & Hannan, Damian F. & Creighton, S., 1989. "Poverty, Income and Welfare in Ireland," Research Series, Economic and Social Research Institute (ESRI), number GRS146.
- Nolan, Brian, 1991. "The Utilisation and Financing of Health Services in Ireland," Research Series, Economic and Social Research Institute (ESRI), number GRS155.
- T Rice & R Labelle, 1989. "Do Physicians Induce Demand for Medical Service?," Centre for Health Economics and Policy Analysis Working Paper Series 18, Centre for Health Economics and Policy Analysis (CHEPA), McMaster University, Hamilton, Canada.
- �ngel Marcos Vera-Hernández, 1999. "Duplicate coverage and demand for health care. The case of Catalonia," Health Economics, John Wiley & Sons, Ltd., vol. 8(7), pages 579-598.
- Carine Van De Voorde & Eddy Van Doorslaer & Erik Schokkaert, 2001. "Effects of cost sharing on physician utilization under favourable conditions for supplier-induced demand," Health Economics, John Wiley & Sons, Ltd., vol. 10(5), pages 457-471.
- Richard Blundell & Monica Costa Dias, 2000. "Evaluation methods for non-experimental data," Fiscal Studies, Institute for Fiscal Studies, vol. 21(4), pages 427-468, January.
When requesting a correction, please mention this item's handle: RePEc:wly:hlthec:v:14:y:2005:i:10:p:1047-1060. 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: (Wiley-Blackwell Digital Licensing)or (Christopher F. Baum)
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.