The impact of accessibility on the use of specialist health care in Norway
What factors contribute to the utilization of specialist health care in Norway, and to what extent is the policy goal of allocating health care according to peoples medical need fulfilled? With this scope the authors analyse the impact of a person's health relative to the impact of access to specialist care. It is distinguished between services provided by public hospitals and services provided by private specialists financed by the National Insurance Scheme. The data allow to consider individual patient characteristics since Survey of Living Conditions data are merged with data on capacity and access to general practice and specialist care. The estimation of logit models and negative binomial models show significant differences between the factors that influence contacts with private specialists and contacts with hospitals. While a person's self-assessed health plays a major role in the utilization of hospitals, there is no significant effect of this variable on the utilization of private specialists. The supply-side variables measured by GP density and the accessibility indices for specialist care have significant effects on the utilization of private specialists, but not on hospital visits and inpatient stays. A preliminary conclusion is that the utilization of hospital services is rationed according to patients' health status, and not influenced by patients' access. Hence, the utilization of hospital services seems to be in accordance with officially stated health policy. On the other hand, private specialists seem to function as an alternative to general practice. Moreover, the significant effect of chronic conditions on the utilization of private specialists suggests that regular check-ups of chronic patients are an important part of the services provided by private specialists. The challenge to policy makers is to consider measures that bring the utilization of publicly funded private specialists in accordance with national health policy.
|Date of creation:||29 Jun 2009|
|Contact details of provider:|| Postal: HERO / Institute of Health Management and Health Economics P.O. Box 1089 Blindern, N-0317 Oslo, Norway|
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- Ulf- G. Gerdtham, 1997.
"Equity in Health Care Utilization: Further Tests Based on Hurdle Models and Swedish Micro Data,"
John Wiley & Sons, Ltd., vol. 6(3), pages 303-319.
- Gerdtham, Ulf-G., 1996. "Equity in Health Care Utilisation: Further Tests Based on Hurdle models and Swedish Micro Data," SSE/EFI Working Paper Series in Economics and Finance 116, Stockholm School of Economics.
- V. Kerry Smith & Donald H. Taylor & Frank A. Sloan, 2001. "Longevity Expectations and Death: Can People Predict Their Own Demise?," American Economic Review, American Economic Association, vol. 91(4), pages 1126-1134, September.
- Smith, V. Kerry & Taylor, Donald H., Jr. & Sloan, Frank A., 2000. "Longevity Expectations and Death: Can People Predict Their Own Demise?," Working Papers 00-15, Duke University, Department of Economics.
- Tor Iversen & Hilde Lurås, 2000. "The effect of capitation on GPs' referral decisions," Health Economics, John Wiley & Sons, Ltd., vol. 9(3), pages 199-210.
- Goddard, Maria & Smith, Peter, 2001. "Equity of access to health care services: : Theory and evidence from the UK," Social Science & Medicine, Elsevier, vol. 53(9), pages 1149-1162, November.
- Cameron, A. Colin & Trivedi, Pravin K., 1990. "Regression-based tests for overdispersion in the Poisson model," Journal of Econometrics, Elsevier, vol. 46(3), pages 347-364, December.
- 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.
- Angel, Ronald & Guarnaccia, Peter J., 1989. "Mind, body, and culture: Somatization among Hispanics," Social Science & Medicine, Elsevier, vol. 28(12), pages 1229-1238, January.
- Paul van den Noord & Terje Hagen & Tor Iversen, 1998. "The Norwegian Health Care System," OECD Economics Department Working Papers 198, OECD Publishing.
- Mullahy, John, 1997. "Heterogeneity, Excess Zeros, and the Structure of Count Data Models," Journal of Applied Econometrics, John Wiley & Sons, Ltd., vol. 12(3), pages 337-350, May-June.
- Roy Carr-Hill & Geoffrey Hardman & Stephen Martin & Stuart Peacock & Trevor Sheldon & Peter Smith, 1994. "A formula for distributing NHS revenues based on small area use of hospital beds," Working Papers 022cheop, Centre for Health Economics, University of York. Full references (including those not matched with items on IDEAS)