Viden om effekten af brugerbetaling i almen praksis og lægevagten

In Denmark GP services are free at the point of use. A looming conflict between GPs and the payor, the Danish Regions, has raised the possibility of copayment during a possible upcoming conflict. Danish empirical evidence on the demand effect of copayment is largely nonexisting. However, from October 1st 1984 to January 5th 1985 there was period with about 40% copayment. Results from the few analyses of the demand effects during this period are summarized. The average copayment for the period was 40% the remaing 60% was reimbursed if an invoice was presented to the municipal office. The total number of contacts decreased with between 4050%. The demand for outofhours service decreased with about the same percentage. The demand for services from a hospital A&E department increased with about 24%. Demand for services from office based specialist decreased with about 10% due to a reduced number of referrals. For office based specialists where referral from GP was not needed the demand was largely unaffected, if anything a slight increase. The 4050% decrease in quantity demanded is not, however, an equilibrium level, in that that the income level of GPs is reduced and most likely will lead to a price adjustment.