Preventive care: underused even when free. A tale from Italy
Despite being strongly recommended for health, preventive care is significantly underused even in countries like Italy where it can be obtained for free. We analyze the determinants of pap test and mammography utilization with an empirical model based on human capital theory. One original feature is the simultaneous inclusion of: health beliefs, general practitioner and non-monetary barriers to access. Using a recursive probit model explaining both recourse to prevention and physician visit, we find evidence to support both Grossman's capital depreciation theory (at younger ages) and Cropper's shorter pay-off period theory (at older ages). We also show that health beliefs play a key role and that the general practitioner hardly affects the decision to undergo preventive treatments. Finally, prevention supply does not appear to be a factor and there is considerable geographical heterogeneity.
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