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A Cross-Sectional Analysis of the Utilisation of GP Services in Ireland: 1987-2001

  • Nolan, Anne

    (Economic and Social Research Institute (ESRI))

  • Nolan, Brian

    (Economic and Social Research Institute (ESRI))

This paper examines the determinants of general practitioner (GP) utilisation patterns in Ireland over the period 1987-2001. Using three different micro-data sets, the influence of socio-economic factors as well as health status variables on the demand for GP visits is analysed. A particular focus of this paper is an examination of the impact of economic incentives as represented by medical card eligibility. While medical cardholders are entitled to free GP consultations, nonmedical cardholders must pay for each visit. In addition, it is important to analyse the impact of the 1989 change in the reimbursement system for GPs with medical cardholder patients from fee for service to capitation. A variety of cross-sectional econometric methodologies are considered with the two-step hurdle negative binomial model found to be the most appropriate. The empirical results confirm the results of earlier studies about the effects of socio-economic characteristics such as age, sex and income on GP utilisation patterns and also confirm the highly significant effects of health status. While medical card eligibility is consistently positive and significant across the years of our analysis (1987, 1995, 2000, 2001), there is no evidence to show that this effect diminished in importance between 1987 and 1995.

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Paper provided by Economic and Social Research Institute (ESRI) in its series Papers with number HRBWP01.

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Length: 48 pages
Date of creation: Nov 2003
Date of revision:
Handle: RePEc:esr:wpaper:hrb01
Note: Published by ESRI, ISSC & University of Ulster
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  1. �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.
  2. 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.
  3. Holly, Alberto & Gardiol, Lucien & Domenighetti, Gianfranco & Brigitte Bisig, 1998. "An econometric model of health care utilization and health insurance in Switzerland," European Economic Review, Elsevier, vol. 42(3-5), pages 513-522, May.
  4. 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.
  5. 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.
  6. 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.
  7. Cameron, A C & P. K. Trivedi & Frank Milne & J. Piggott, 1988. "A Microeconometric Model of the Demand for Health Care and Health Insurance in Australia," Review of Economic Studies, Wiley Blackwell, vol. 55(1), pages 85-106, January.
  8. 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.
  9. 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).
  10. Martin Schellhorn, 2001. "The effect of variable health insurance deductibles on the demand for physician visits," Health Economics, John Wiley & Sons, Ltd., vol. 10(5), pages 441-456.
  11. Colm Harmon & Brian Nolan, 2001. "Health insurance and health services utilization in Ireland," Health Economics, John Wiley & Sons, Ltd., vol. 10(2), pages 135-145.
  12. Nolan, Brian, 1993. "Economic incentives, health status and health services utilisation," Journal of Health Economics, Elsevier, vol. 12(2), pages 151-169, July.
  13. Nolan, Brian, 1991. "The Utilisation and Financing of Health Services in Ireland," Research Series, Economic and Social Research Institute (ESRI), number GRS155.
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