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

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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File URL: http://www.uib.no/filearchive/No.%2016-05.pdf
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Paper provided by University of Bergen, Department of Economics in its series Working Papers in Economics with number 16/05.

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Length: 24 pages
Date of creation: 05 Jun 2005
Date of revision:
Handle: RePEc:hhs:bergec:2005_016
Contact details of provider: Postal: Institutt for økonomi, Universitetet i Bergen, Postboks 7802, 5020 Bergen, Norway
Phone: (+47)55589200
Fax: (+47)55589210
Web page: http://www.uib.no/econ/en
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  1. John Robst & Glenn Graham, 1997. "Access to health care and current health status: do physicians matter?," Applied Economics Letters, Taylor & Francis Journals, vol. 4(1), pages 45-48.
  2. Blundell, R. & Bond, S., 1995. "Initial Conditions and Moment Restrictions in Dynamic Panel Data Models," Economics Papers 104, Economics Group, Nuffield College, University of Oxford.
  3. John Geweke & Gautam Gowrisankaran & Robert J. Town, 2001. "Bayesian Inference for Hospital Quality in a Selection Model," NBER Working Papers 8497, National Bureau of Economic Research, Inc.
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  6. Angus S. Deaton & Christina Paxson, 2001. "Mortality, Education, Income, and Inequality among American Cohorts," NBER Chapters, in: Themes in the Economics of Aging, pages 129-170 National Bureau of Economic Research, Inc.
  7. Cutler, D.M., 1992. "The Incidence of Adverse Medical Outcome Under Prospective Payment," Harvard Institute of Economic Research Working Papers 1603, Harvard - Institute of Economic Research.
  8. Theodore Joyce & Naci Mocan, 1993. "Unemployment and Infant Health: Time-Series Evidence from the State of Tennessee," Journal of Human Resources, University of Wisconsin Press, vol. 28(1), pages 185-203.
  9. David Cutler & Ellen Meara, 2001. "Changes in the Age Distribution of Mortality Over the 20th Century," NBER Working Papers 8556, National Bureau of Economic Research, Inc.
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  11. Or, Zeynep & Wang, Jia & Jamison, Dean, 2005. "International differences in the impact of doctors on health: a multilevel analysis of OECD countries," Journal of Health Economics, Elsevier, vol. 24(3), pages 531-560, May.
  12. Ruhm, Christopher J., 2003. "Good times make you sick," Journal of Health Economics, Elsevier, vol. 22(4), pages 637-658, July.
  13. Daniel P. Kessler & Mark B. McClellan, 2000. "Is Hospital Competition Socially Wasteful?," The Quarterly Journal of Economics, MIT Press, vol. 115(2), pages 577-615, May.
  14. Gravelle, Hugh S. E., 1984. "Time series analysis of mortality and unemployment," Journal of Health Economics, Elsevier, vol. 3(3), pages 297-305, December.
  15. John Robst, 2001. "A note on the relationship between medical care resources and mortality," Applied Economics Letters, Taylor & Francis Journals, vol. 8(11), pages 737-739.
  16. Forbes, John F. & McGregor, Alan, 1984. "Unemployment and mortality in post-war Scotland," Journal of Health Economics, Elsevier, vol. 3(3), pages 239-257, December.
  17. Hitiris, Theo & Posnett, John, 1992. "The determinants and effects of health expenditure in developed countries," Journal of Health Economics, Elsevier, vol. 11(2), pages 173-181, August.
  18. Kemna, Harrie J. M. I., 1987. "Working conditions and the relationship between schooling and health," Journal of Health Economics, Elsevier, vol. 6(3), pages 189-210, September.
  19. Arellano, Manuel & Bond, Stephen, 1991. "Some Tests of Specification for Panel Data: Monte Carlo Evidence and an Application to Employment Equations," Review of Economic Studies, Wiley Blackwell, vol. 58(2), pages 277-97, April.
  20. Carlsen, Fredrik & Grytten, Jostein, 2000. "Consumer satisfaction and supplier induced demand," Journal of Health Economics, Elsevier, vol. 19(5), pages 731-753, September.
  21. M Arellano & O Bover, 1990. "Another Look at the Instrumental Variable Estimation of Error-Components Models," CEP Discussion Papers dp0007, Centre for Economic Performance, LSE.
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