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Does the extension of primary care practice opening hours reduce the use of emergency services?

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  • M. Lippi Bruni
  • I. Mammi
  • C. Ugolini

Abstract

Over-crowding in Emergency Departments (EDs) generates potential inefficiencies. Using regional administrative data, we investigate the impact of an increase in the accessibility of primary care on ED visits in Italy. We test whether extending practice opening hours up to 12 hours/day reduces inappropriate ED visits. We estimate count data models, considering different measures for ED visits recorded at the list level. Since the extension programme is voluntary, we also account for the potential endogeneity of participation, using a two-stage residual inclusion and a GMM approach. Our results show that improving primary care accessibility favours a more appropriate use of EDs.

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  • M. Lippi Bruni & I. Mammi & C. Ugolini, 2014. "Does the extension of primary care practice opening hours reduce the use of emergency services?," Working Papers wp978, Dipartimento Scienze Economiche, Universita' di Bologna.
    • Handle: RePEc:bol:bodewp:wp978
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    Cited by:

    1. Dolton, Peter & Pathania, Vikram, 2016. "Can increased primary care access reduce demand for emergency care? Evidence from England's 7-day GP opening," Journal of Health Economics, Elsevier, vol. 49(C), pages 193-208.
    2. Ugolini, Cristina & Lippi Bruni, Matteo & Leucci, Anna Caterina & Fiorentini, Gianluca & Berti, Elena & Nobilio, Lucia & Moro, Maria Luisa, 2019. "Disease management in diabetes care: When involving GPs improves patient compliance and health outcomes," Health Policy, Elsevier, vol. 123(10), pages 955-962.
    3. Mauro Laudicella & Paolo Li Donni, 2022. "The dynamic interdependence in the demand of primary and emergency secondary care: A hidden Markov approach," Journal of Applied Econometrics, John Wiley & Sons, Ltd., vol. 37(3), pages 521-536, April.
    4. Alexander, Diane & Currie, Janet & Schnell, Molly, 2019. "Check up before you check out: Retail clinics and emergency room use," Journal of Public Economics, Elsevier, vol. 178(C).
    5. Matteo Lippi Bruni & Cristina Ugolini & Rossella Verzulli & Anna Caterina Leucci, 2023. "The impact of Community Health Centers on inappropriate use of emergency services," Health Economics, John Wiley & Sons, Ltd., vol. 32(2), pages 375-394, February.
    6. Pak, Anton & Gannon, Brenda & Staib, Andrew, 2020. "Forecasting Waiting Time to Treatment for Emergency Department Patients," OSF Preprints d25se, Center for Open Science.
    7. Hong, Michael & Thind, Amardeep & Zaric, Gregory S. & Sarma, Sisira, 2020. "The impact of improved access to after-hours primary care on emergency department and primary care utilization: A systematic review," Health Policy, Elsevier, vol. 124(8), pages 812-818.
    8. Matteo Lippi Bruni & Irene Mammi, 2017. "Spatial effects in hospital expenditures: A district level analysis," Health Economics, John Wiley & Sons, Ltd., vol. 26(S2), pages 63-77, September.
    9. Lippi Bruni, Matteo & Ugolini, Cristina & Verzulli, Rossella, 2021. "Should I wait or should I go? Travelling versus waiting for better healthcare," Regional Science and Urban Economics, Elsevier, vol. 89(C).
    10. Liang-Chung Huang & Wu-Fu Chung & Shih-Wei Liu & Jau-Ching Wu & Li-Fu Chen & Yu-Chun Chen, 2019. "Characteristics of Non-Emergent Visits in Emergency Departments: Profiles and Longitudinal Pattern Changes in Taiwan, 2000–2010," IJERPH, MDPI, vol. 16(11), pages 1-16, June.
    11. Serrano-Alarcón, Manuel & Hernández-Pizarro, Helena & López-Casasnovas, Guillem & Nicodemo, Catia, 2022. "Effects of long-term care benefits on healthcare utilization in Catalonia," Journal of Health Economics, Elsevier, vol. 84(C).
    12. Manuel Serrano-Alarcón & Helena Hernández-Pizarro & Guillem López i Casasnovas & Catia Nicodemo, 2021. "The effect of Long-Term Care (LTC) benefits on healthcare use," Working Papers 2021-12, FEDEA.
    13. Paolo Cremonesi & Enrico Bella & Marcello Montefiori & Luca Persico, 2015. "The Robustness and Effectiveness of the Triage System at Times of Overcrowding and the Extra Costs due to Inappropriate Use of Emergency Departments," Applied Health Economics and Health Policy, Springer, vol. 13(5), pages 507-514, October.
    14. Gaillard, Aurélie & García-Lorenzo, Borja & Renaud, Thomas & Wittwer, Jérôme, 2022. "Does integrated care mean fewer hospitalizations? An evaluation of a French field experiment," Health Policy, Elsevier, vol. 126(8), pages 786-794.
    15. David, Guy & Smith-McLallen, Aaron & Ukert, Benjamin, 2019. "The effect of predictive analytics-driven interventions on healthcare utilization," Journal of Health Economics, Elsevier, vol. 64(C), pages 68-79.
    16. Pinchbeck, Edward W., 2019. "Convenient primary care and emergency hospital utilisation," Journal of Health Economics, Elsevier, vol. 68(C).
    17. Yiu-Shing Lau & Gintare Malisauskaite & Nadia Brookes & Shereen Hussein & Matt Sutton, 2021. "Complements or substitutes? Associations between volumes of care provided in the community and hospitals," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 22(8), pages 1167-1181, November.
    18. Behrens, Doris A. & Morgan, Jennifer S. & Krczal, Eva & Harper, Paul R. & Gartner, Daniel, 2023. "Still looking in the wrong place: Literature-based evidence of why patients really attend an emergency department," Socio-Economic Planning Sciences, Elsevier, vol. 90(C).
    19. Vanessa Ress & Eva‐Maria Wild, 2024. "The impact of integrated care on health care utilization and costs in a socially deprived urban area in Germany: A difference‐in‐differences approach within an event‐study framework," Health Economics, John Wiley & Sons, Ltd., vol. 33(2), pages 229-247, February.
    20. Shen, Menghan & He, Wen & Li, Linyan, 2020. "Incentives to use primary care and their impact on healthcare utilization: Evidence using a public health insurance dataset in China," Social Science & Medicine, Elsevier, vol. 255(C).
    21. Krämer, Jonas & Schreyögg, Jonas, 2019. "Substituting emergency services: primary care vs. hospital care," Health Policy, Elsevier, vol. 123(11), pages 1053-1060.
    22. Andrea Cintolesi & Andrea Riganti, 2022. "Liberalizing the opening of new pharmacies and hospitalizations," Temi di discussione (Economic working papers) 1388, Bank of Italy, Economic Research and International Relations Area.
    23. Qiling Lu & Jing Hua, 2023. "Micro-Household Human Capital Investment Decisions and a Simulation Study from the Intergenerational Conflict Perspective," IJERPH, MDPI, vol. 20(3), pages 1-21, January.
    24. Pak, Anton & Gannon, Brenda, 2021. "Do access, quality and cost of general practice affect emergency department use?," Health Policy, Elsevier, vol. 125(4), pages 504-511.

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    • I11 - Health, Education, and Welfare - - Health - - - Analysis of Health Care Markets
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health
    • C31 - Mathematical and Quantitative Methods - - Multiple or Simultaneous Equation Models; Multiple Variables - - - Cross-Sectional Models; Spatial Models; Treatment Effect Models; Quantile Regressions; Social Interaction Models

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