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The Demand for Physician Services. Evidence from a Natural Experiment

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  • Bart COCKX

    (UNIVERSITE CATHOLIQUE DE LOUVAIN, Institut de Recherches Economiques et Sociales (IRES))

  • Carine BRASSEUR

Abstract

This study exploits a natural experiment in Belgium to estimate the effect of co-payment increases on the demand for physician services. It shows how a differences-in-differences estimator of the price effects can be decomposed into effects induced by the common average proportional price increase (income effects) and by the change in relative prices (substitution effects). The price elasticity of a uniform proportional price increase is relatively small (-.13 for mean and -.03 for woman). Substitution effects are large, especially for women, but imprecisely estimated. Despite the substantial price increases, the efficiency gain of the reform, if any, is modest

Suggested Citation

  • 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).
  • Handle: RePEc:ctl:louvir:2001027
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    File URL: http://sites.uclouvain.be/econ/DP/IRES/2001-27.pdf
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    References listed on IDEAS

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    Cited by:

    1. Paolo Buonanno & Matteo M. Galizzi, 2012. "Advocatus, et non Latro? Testing the Supplier-Induced Demand Hypothesis for the Italian Courts of Justice," Carlo Alberto Notebooks 250, Collegio Carlo Alberto.
    2. Poulsen, Camilla Aavang, 2014. "Introducing out-of-pocket payment for General Practice in Denmark: Feasibility and support," Health Policy, Elsevier, vol. 117(1), pages 64-71.
    3. Erik Schokkaert & Carine Van de Voorde, 2005. "Health care reform in Belgium," Health Economics, John Wiley & Sons, Ltd., vol. 14(S1), pages 25-39.
    4. Yoshida, Atsushi & Kawamura, Akira, 2009. "Who has benefited from the health services system for the elderly in Japan?," Japan and the World Economy, Elsevier, vol. 21(3), pages 256-269, August.
    5. Jakobsson, Niklas & Svensson, Mikael, 2016. "Copayments and physicians visits: A panel data study of Swedish regions 2003–2012," Health Policy, Elsevier, vol. 120(9), pages 1095-1099.
    6. Buonanno Paolo & Galizzi Matteo M., 2014. "Advocatus, et non Latro? Testing the Excess of Litigation in the Italian Courts of Justice," Review of Law & Economics, De Gruyter, vol. 10(3), pages 1-38, November.
    7. repec:eee:jhecon:v:58:y:2018:i:c:p:90-109 is not listed on IDEAS
    8. Astrid Kiil & Kurt Houlberg, 2014. "How does copayment for health care services affect demand, health and redistribution? A systematic review of the empirical evidence from 1990 to 2011," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 15(8), pages 813-828, November.
    9. Mamas Theodorou, 2014. "Testing the Waters for GeSY: Patients’ Opinion of Cost-sharing Arrangements in the Public Health Care System in Cyprus," Cyprus Economic Policy Review, University of Cyprus, Economics Research Centre, vol. 8(2), pages 37-59, December.
    10. Galina Besstremyannaya, 2014. "Heterogeneous effect of coinsurance rate on healthcare costs: generalized finite mixtures and matching estimators," Discussion Papers 14-014, Stanford Institute for Economic Policy Research.
    11. Ziebarth N, 2009. "“Do I really need to go to rehab? I’d say no, no, no.” Estimating Price Elasticities of Convalescent Care Programs," Health, Econometrics and Data Group (HEDG) Working Papers 09/27, HEDG, c/o Department of Economics, University of York.
    12. Paolo Buonanno & Matteo M. Galizzi, 2009. "Advocatus, et non latro? Testing the supplier-induced demand hypothesis for Italian courts of justice," Working Papers 0914, University of Brescia, Department of Economics.
    13. 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.
    14. Nicolas Ziebarth, 2014. "Assessing the effectiveness of health care cost containment measures: evidence from the market for rehabilitation care," International Journal of Health Economics and Management, Springer, vol. 14(1), pages 41-67, March.
    15. Jana Votapkova & Pavlina Zilova, 2016. "The abolition of user charges and the demand for ambulatory visits: evidence from the Czech Republic," Health Economics Review, Springer, vol. 6(1), pages 1-11, December.
    16. NicolasR. Ziebarth, 2010. "Estimating Price Elasticities of Convalescent Care Programmes," Economic Journal, Royal Economic Society, vol. 120(545), pages 816-844, June.
    17. repec:eee:socmed:v:205:y:2018:i:c:p:99-106 is not listed on IDEAS
    18. Philipp Hafner & Jörg C. Mahlich, 2016. "Determinants of physician's office visits and potential effects of co-payments: evidence from Austria," International Journal of Health Planning and Management, Wiley Blackwell, vol. 31(3), pages 192-203, July.
    19. Mas, Nuria & Cirera, Laia & Viñolas, Guillem, 2011. "Los sistemas de copago en Europa, Estados Unidos y Canadá: Implicaciones para el caso español," IESE Research Papers D/939, IESE Business School.
    20. Krůtilová, Veronika & Yaya, Sanni, 2012. "Unexpected impact of changes in out-of-pocket payments for health care on Czech household budgets," Health Policy, Elsevier, vol. 107(2), pages 276-288.
    21. Ha Trong Nguyen & Luke B Connelly, 2017. "Cost-sharing in health insurance and its impact in a developing country: evidence from a quasi-natural experiment," Bankwest Curtin Economics Centre Working Paper series WP1702, Bankwest Curtin Economics Centre (BCEC), Curtin Business School.

    More about this item

    Keywords

    health care; physician service; co-payment; moral hazard; demand system; differences-in-differences estimator;

    JEL classification:

    • C33 - Mathematical and Quantitative Methods - - Multiple or Simultaneous Equation Models; Multiple Variables - - - Models with Panel Data; Spatio-temporal Models
    • D12 - Microeconomics - - Household Behavior - - - Consumer Economics: Empirical Analysis
    • I11 - Health, Education, and Welfare - - Health - - - Analysis of Health Care Markets
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health

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