IDEAS home Printed from https://ideas.repec.org/a/spr/aphecp/v15y2017i5d10.1007_s40258-017-0325-y.html
   My bibliography  Save this article

User Fees in General Practice: Willingness to Pay and Potential Substitution Patterns—Results from a Danish GP Patient Survey

Author

Listed:
  • Christian Kronborg

    (University of Southern Denmark, Centre of Health Economics Research (COHERE))

  • Line Bjørnskov Pedersen

    (University of Southern Denmark, Centre of Health Economics Research (COHERE)
    University of Southern Denmark)

  • Anders Fournaise

    (Region of Southern Denmark
    Odense University Hospital)

  • Christel Nøhr Kronborg

    (Lægerne Nyenstad)

Abstract

Background Increases in public expenditures to general practitioner (GP) services and specialist care have spurred debate over whether to implement user fees for healthcare services such as GP consultations in Denmark. Objective The objective of this study was to examine Danish patients’ attitudes towards user fees and their willingness to pay (WTP) for a consultation, and to investigate how user charges may impact patients’ behaviour. Methods A questionnaire survey was conducted in a GP clinic. Results A total of 343 individual persons answered the questionnaire. One hundred and seventy (50%) persons were not willing to pay for a consultation. Among patients reporting positive WTP values, the mean WTP was 137 (standard deviation 140) Danish kroner (DKK). Patients who were 65 years old or older were more likely to be willing to pay for a GP consultation than patients under the age of 65 years. Furthermore, patients with a personal annual income of more than 200,000 DKK were more likely to be willing to pay for a consultation than other income groups. With respect to patients with a positive WTP value, their own assessment of the seriousness of the consultation and their self-assessed health influenced the amount they would be willing to pay. Finally, we observed a stated willingness to substitute GP consultations with alternatives that are free of charge. Conclusion About half of the patients with an appointment for a GP consultation are willing to pay for the consultation. User charges may potentially influence the patients’ behaviour. ClinicalTrials.gov NCT01784731.

Suggested Citation

  • Christian Kronborg & Line Bjørnskov Pedersen & Anders Fournaise & Christel Nøhr Kronborg, 2017. "User Fees in General Practice: Willingness to Pay and Potential Substitution Patterns—Results from a Danish GP Patient Survey," Applied Health Economics and Health Policy, Springer, vol. 15(5), pages 615-624, October.
    • Handle: RePEc:spr:aphecp:v:15:y:2017:i:5:d:10.1007_s40258-017-0325-y
    DOI: 10.1007/s40258-017-0325-y
    as

    Download full text from publisher

    File URL: http://link.springer.com/10.1007/s40258-017-0325-y
    File Function: Abstract
    Download Restriction: Access to the full text of the articles in this series is restricted.
    File URL: https://libkey.io/10.1007/s40258-017-0325-y?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    As the access to this document is restricted, you may want to search for a different version of it.

    References listed on IDEAS

    as
    1. Manning, Willard G, et al, 1987. "Health Insurance and the Demand for Medical Care: Evidence from a Randomized Experiment," American Economic Review, American Economic Association, vol. 77(3), pages 251-277, June.
    2. Hermann Donfouet & Pierre-Alexandre Mahieu & Eric Malin, 2013. "Using respondents’ uncertainty scores to mitigate hypothetical bias in community-based health insurance studies," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 14(2), pages 277-285, April.
    3. Poulsen, Camilla Aavang, 2014. "Introducing out-of-pocket payment for General Practice in Denmark: Feasibility and support," Health Policy, Elsevier, vol. 117(1), pages 64-71.
    4. Layte, Richard & Nolan, Anne & McGee, Hannah & O'Hanlon, Ann, 2009. "Do consultation charges deter general practitioner use among older people? A natural experiment," Social Science & Medicine, Elsevier, vol. 68(8), pages 1432-1438, April.
    5. Cam Donaldson & Andrew Jones & Tracy Mapp & Jan Abel Olson, 1998. "Limited dependent variables in willingness to pay studies: applications in health care," Applied Economics, Taylor & Francis Journals, vol. 30(5), pages 667-677.
    6. Kjeld Møller Pedersen & Terkel Christiansen & Mickael Bech, 2005. "The Danish health care system: evolution ‐ not revolution ‐ in a decentralized system," Health Economics, John Wiley & Sons, Ltd., vol. 14(S1), pages 41-57, September.
    7. Zweifel, Peter & Manning, Willard G., 2000. "Moral hazard and consumer incentives in health care," Handbook of Health Economics, in: A. J. Culyer & J. P. Newhouse (ed.), Handbook of Health Economics, edition 1, volume 1, chapter 8, pages 409-459, Elsevier.
    8. Pedersen, Kjeld Møller, 2013. "Viden om effekten af brugerbetaling i almen praksis og lægevagten," DaCHE discussion papers 2013:3, University of Southern Denmark, Dache - Danish Centre for Health Economics.
    Full references (including those not matched with items on IDEAS)

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Peter Zweifel, 2006. "Auftrag und Grenzen der Sozialen Krankenversicherung," Perspektiven der Wirtschaftspolitik, Verein für Socialpolitik, vol. 7(s1), pages 5-26, May.
    2. Ma, Yuanyuan & Nolan, Anne & Smith, James P., 2020. "Free GP care and psychological health: Quasi-experimental evidence from Ireland," Journal of Health Economics, Elsevier, vol. 72(C).
    3. Tamie Matsuura & Masaru Sasaki, 2012. "Can the health insurance reforms stop an increase in medical expenditures for middle- and old-aged persons in Japan?," International Journal of Health Economics and Management, Springer, vol. 12(2), pages 163-187, June.
    4. Ellis, Randall P. & Jiang, Shenyi & Manning, Willard G., 2015. "Optimal health insurance for multiple goods and time periods," Journal of Health Economics, Elsevier, vol. 41(C), pages 89-106.
    5. Karl-Michael Ortmann, 2011. "Optimal deductibles for outpatient services," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 12(1), pages 39-47, February.
    6. Richard Layte & Anne Nolan, 2015. "Eligibility for free GP care and the utilisation of GP services by children in Ireland," International Journal of Health Economics and Management, Springer, vol. 15(1), pages 3-27, March.
    7. Kurt Lavetti & Thomas DeLeire & Nicolas R. Ziebarth, 2023. "How do low‐income enrollees in the Affordable Care Act marketplaces respond to cost‐sharing?," Journal of Risk & Insurance, The American Risk and Insurance Association, vol. 90(1), pages 155-183, March.
    8. Sepehri, Ardeshir & Simpson, Wayne & Sarma, Sisira, 2006. "The influence of health insurance on hospital admission and length of stay--The case of Vietnam," Social Science & Medicine, Elsevier, vol. 63(7), pages 1757-1770, October.
    9. Hudson, Eibhlin & Nolan, Anne, 2015. "Public healthcare eligibility and the utilisation of GP services by older people in Ireland," The Journal of the Economics of Ageing, Elsevier, vol. 6(C), pages 24-43.
    10. Andreas Werblow, 2002. "Alles nur Selektion?: Der Einfluss von Selbstbehalten in der Gesetzlichen Krankenversicherung," Vierteljahrshefte zur Wirtschaftsforschung / Quarterly Journal of Economic Research, DIW Berlin, German Institute for Economic Research, vol. 71(4), pages 427-436.
    11. Ha Trong Nguyen & Luke B Connelly, 2017. "Cost-sharing in health insurance and its impact in a developing country: evidence from a quasi-natural experiment," Bankwest Curtin Economics Centre Working Paper series WP1702, Bankwest Curtin Economics Centre (BCEC), Curtin Business School.
    12. Matthew Jowett & Anil Deolalikar & Peter Martinsson, 2004. "Health insurance and treatment seeking behaviour: evidence from a low‐income country," Health Economics, John Wiley & Sons, Ltd., vol. 13(9), pages 845-857, September.
    13. NicolasR. Ziebarth, 2010. "Estimating Price Elasticities of Convalescent Care Programmes," Economic Journal, Royal Economic Society, vol. 120(545), pages 816-844, June.
    14. Andrey Aistov & Ekaterina Aleksandrova & Christopher J. Gerry, 2021. "Voluntary private health insurance, health-related behaviours and health outcomes: evidence from Russia," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 22(2), pages 281-309, March.
    15. Carine Van De Voorde & Eddy Van Doorslaer & Erik Schokkaert, 2001. "Effects of cost sharing on physician utilization under favourable conditions for supplier‐induced demand," Health Economics, John Wiley & Sons, Ltd., vol. 10(5), pages 457-471, July.
    16. Nicolas Ziebarth, 2014. "Assessing the effectiveness of health care cost containment measures: evidence from the market for rehabilitation care," International Journal of Health Economics and Management, Springer, vol. 14(1), pages 41-67, March.
    17. Yuanyuan Ma & Anne Nolan, 2017. "Public Healthcare Entitlements and Healthcare Utilisation among the Older Population in Ireland," Health Economics, John Wiley & Sons, Ltd., vol. 26(11), pages 1412-1428, November.
    18. Cockx, Bart & Brasseur, Carine, 2003. "The demand for physician services: Evidence from a natural experiment," Journal of Health Economics, Elsevier, vol. 22(6), pages 881-913, November.
    19. Ziebarth N, 2009. "“Do I really need to go to rehab? I’d say no, no, no.” Estimating Price Elasticities of Convalescent Care Programs," Health, Econometrics and Data Group (HEDG) Working Papers 09/27, HEDG, c/o Department of Economics, University of York.
    20. van Kleef, R.C. & van de Ven, W.P.M.M. & van Vliet, R.C.J.A., 2009. "Shifted deductibles for high risks: More effective in reducing moral hazard than traditional deductibles," Journal of Health Economics, Elsevier, vol. 28(1), pages 198-209, January.

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:spr:aphecp:v:15:y:2017:i:5:d:10.1007_s40258-017-0325-y. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Sonal Shukla or Springer Nature Abstracting and Indexing (email available below). General contact details of provider: http://www.springer.com .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.