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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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  • Nolan, Anne & Nolan, Brian, 2003. "A Cross-Sectional Analysis of the Utilisation of GP Services in Ireland: 1987-2001," Papers HRBWP01, Economic and Social Research Institute (ESRI).
  • Handle: RePEc:esr:wpaper:hrb01
    Note: Published by ESRI, ISSC & University of Ulster

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    References listed on IDEAS

    1. 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.
    2. 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.
    3. 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.
    4. Ángel 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.
    5. 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.
    6. 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.
    7. 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.
    8. Nolan, Brian, 1991. "The Utilisation and Financing of Health Services in Ireland," Research Series, Economic and Social Research Institute (ESRI), number GRS155.
    9. Nolan, Brian, 1993. "Economic incentives, health status and health services utilisation," Journal of Health Economics, Elsevier, vol. 12(2), pages 151-169, July.
    10. Sergi Jiménez-Martín & José M. Labeaga & Maite Martínez-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.
    11. 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.
    12. A. C. Cameron & 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, Oxford University Press, vol. 55(1), pages 85-106.
    13. 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.
    14. 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.
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    Cited by:

    1. McGregor, P. & Nolan, Anne & Nolan, Brian & O'Neill, C., 2006. "A Comparison of GP Visiting in Northern Ireland and the Republic of Ireland," Papers HRBWP22, Economic and Social Research Institute (ESRI).
    2. Nolan, Anne & Nolan, Brian, 2004. "Ireland's Health Care System: Some Issues and Challenges," Papers BP2005/3, Economic and Social Research Institute (ESRI).
    3. Jacqueline O'Reilly & Miriam M. Wiley, 2007. "The Public/Private Mix in Irish Acute Public Hospitals: Trends and Implications," Papers WP218, Economic and Social Research Institute (ESRI).
    4. Pat McGregor & Pat McKee & Ciaran O’Neill, 2006. "GP Utilisation in Northern Ireland - Exploiting the Gatekeeper Function," The Economic and Social Review, Economic and Social Studies, vol. 37(1), pages 71-90.
    5. Nolan, Anne & Nolan, Brian, 2007. "Income, Medical Card Eligibility and Access to GP Services in Ireland," Book Chapters,in: Nolan, Brian (ed.), The Provision and Use of Health Services, Health Inequalities and Health and Social Gain Economic and Social Research Institute (ESRI).
    6. Smith, Samantha, 2007. "Emergency Department Utilisation in Four Irish Teaching Hospitals," Papers HRBWP26, Economic and Social Research Institute (ESRI).
    7. Callan, Tim & Nolan, Brian, 2004. "Relative Income Poverty: Learning from the Best-Performing Countries," Papers BP2005/2, Economic and Social Research Institute (ESRI).
    8. Garrett, Shane & Mathieu, Catherine & Nolan, Anne & Nolan, Brian & Sterdyniak, Henri, 2004. "Budget Perspectives 2005," Research Series, Economic and Social Research Institute (ESRI), number BMI176 edited by Callan, Tim & Doris, Aedin & McCoy, Daniel.
    9. Nolan, Anne & Nolan, Brian, 2004. "A Panel Data Analysis of The Utilisation of GP Services in Ireland: 1995-2001," Papers HRBWP13, Economic and Social Research Institute (ESRI).

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