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Access to Primary Health Care and Health Outcomes: The Relationships between GP Characteristics and Mortality Rates

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This paper analyses the impact of economic conditions and access to primary health care on health outcomes in Norway. Total mortality rates, grouped into four causes of death, were used as proxies for health, and the number of general practitioners (GPs) at the municipality level was used as the proxy for access to primary health care. Dynamic panel data models that allow for time persistence in mortality rates, incorporate municipal fixed effects, and treat both the number and types of GPs in a district as endogenous were estimated using municipality data from 1986 to 2001. We reject the significant relationship between mortality and the number of GPs per capita found in most previous studies. However, there is a significant effect of the composition of GPs, where an increase in the number of fee-for-service GPs reduces mortality rates when compared with GPs employed directly by the municipality.

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  • Aakvik, Arild & Holmås, Tor Helge, 2005. "Access to Primary Health Care and Health Outcomes: The Relationships between GP Characteristics and Mortality Rates," Working Papers in Economics 16/05, University of Bergen, Department of Economics.
  • Handle: RePEc:hhs:bergec:2005_016
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    Cited by:

    1. Farahani, Mansour & Subramanian, S.V. & Canning, David, 2009. "The effect of changes in health sector resources on infant mortality in the short-run and the long-run: A longitudinal econometric analysis," Social Science & Medicine, Elsevier, vol. 68(11), pages 1918-1925, June.
    2. Yusuke Kamiya, 2010. "Determinants of Health in Developing Countries:Cross-Country Evidence," OSIPP Discussion Paper 10E009, Osaka School of International Public Policy, Osaka University.
    3. Fichera, Eleonora & Emsley, Richard & Sutton, Matt, 2016. "Is treatment “intensity” associated with healthier lifestyle choices? An application of the dose response function," Economics & Human Biology, Elsevier, vol. 23(C), pages 149-163.
    4. Sundmacher, Leonie & Busse, Reinhard, 2011. "The impact of physician supply on avoidable cancer deaths in Germany. A spatial analysis," Health Policy, Elsevier, vol. 103(1), pages 53-62.
    5. Liebert, H. & Mäder, B., 2016. "Marginal effects of physician coverage on infant and disease mortality," Health, Econometrics and Data Group (HEDG) Working Papers 16/17, HEDG, c/o Department of Economics, University of York.
    6. David Granlund, 2010. "The effect of health care expenditure on sickness absence," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 11(6), pages 555-568, December.
    7. Liebert, Helge & Mäder, Beatrice, 2017. "The impact of regional health care coverage on infant mortality and disease incidence," Annual Conference 2017 (Vienna): Alternative Structures for Money and Banking 168103, Verein für Socialpolitik / German Economic Association.
    8. Aaltonen, Juho, 2007. "Determinants of Health Care Expenditures in Finnish Hospital Districts 1993-2005," Discussion Papers 429, Government Institute for Economic Research Finland (VATT).
    9. Granlund, David, 2007. "The effect of health care expenditure on sickness absence," Umeå Economic Studies 701, Umeå University, Department of Economics, revised 13 Apr 2007.
    10. Liebert, Helge & Mäder, Beatrice, 2016. "The impact of regional health care coverage on infant mortality and disease incidence," Economics Working Paper Series 1620, University of St. Gallen, School of Economics and Political Science.
    11. Aakvik, Arild & Holmås, Tor Helge & Islam, M. Kamrul, 2011. "Does variation in GP practice matter for the length of sick leave? A multilevel analysis based on Norwegian GP—patient data," Working Papers in Economics 17/08, University of Bergen, Department of Economics.
    12. Van Gestel, R.; Müller, T.; Bosmans, J.;, 2017. "Learning from failure in healthcare: dynamic panel evidence of a physician shock effect," Health, Econometrics and Data Group (HEDG) Working Papers 17/24, HEDG, c/o Department of Economics, University of York.
    13. Aakvik, Arild & Holmås, Tor Helge & Kamrul Islam, M., 2010. "Does variation in general practitioner (GP) practice matter for the length of sick leave? A multilevel analysis based on Norwegian GP-patient data," Social Science & Medicine, Elsevier, vol. 70(10), pages 1590-1598, May.
    14. Mansour Farahani & S. V. Subramanian & David Canning, 2009. "Short and long-term relationship between physician density on infant mortality: a longitudinal econometric analysis," PGDA Working Papers 4909, Program on the Global Demography of Aging.

    More about this item

    Keywords

    general practitioners (GPs); mortality; morbidity; simultaneity; endogeneity; municipalities; dynamic panel data models;

    JEL classification:

    • I11 - Health, Education, and Welfare - - Health - - - Analysis of Health Care Markets
    • I12 - Health, Education, and Welfare - - Health - - - Health Behavior
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health

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