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Exploring the determinants of endocrinologist visits by patients with diabetes

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  • Luiz Flavio Andrade

    (MGEN Foundation for Public Health
    University of Paris Descartes)

  • Thomas Rapp

    (University of Paris Descartes)

  • Christine Sevilla-Dedieu

    (MGEN Foundation for Public Health)

Abstract

Background Diabetes is today a major public health concern in terms of its financial and social burden. Previous studies have revealed that specialist care for patients with diabetes leads to more positive outcomes than care by general practitioners (GPs) alone. The aim of this study was to estimate the determinants of endocrinologist consultation by patients with diabetes. Methods We used a two-part model to explore both the decision to consult and the frequency of consultations. We used claim data collected for 65,633 affiliates of a French social security provider. Patients were aged over 18 and treated for diabetes (types I and II). We controlled for patients’ socioeconomic characteristics, type of diabetes treatment, medical care, and health status. We also controlled for variables, such as the cost of a visit, the distance to the nearest endocrinologist’s office, the density of medical practitioners and the prevalence of diabetes in the area. Results The results show that the parameters associated with the decision to consult an endocrinologist were considerably different from factors associated with the frequency of consultations. A marked positive effect of income on the decision to consult was found, whereas travel time to the office had a negative impact on both the decision to consult and the frequency of consultations. Increasing treatment complexity is associated with a higher probability of consulting an endocrinologist. We found evidence of a significant substitution effect between GPs and endocrinologists. Finally, consultation price is a barrier to seeing an endocrinologist. Conclusion Given that financial barriers were identified in the relatively wealthy population analysed here, it is likely that this may be even more of an obstacle in the general population.

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  • Luiz Flavio Andrade & Thomas Rapp & Christine Sevilla-Dedieu, 2016. "Exploring the determinants of endocrinologist visits by patients with diabetes," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 17(9), pages 1173-1184, December.
    • Handle: RePEc:spr:eujhec:v:17:y:2016:i:9:d:10.1007_s10198-016-0794-1
    DOI: 10.1007/s10198-016-0794-1
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    Cited by:

    1. Clémence Bussière & Nicolas Sirven & Thomas Rapp & Christine Sevilla‐Dedieu, 2020. "Adherence to medical follow‐up recommendations reduces hospital admissions: Evidence from diabetic patients in France," Health Economics, John Wiley & Sons, Ltd., vol. 29(4), pages 508-522, April.

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    More about this item

    Keywords

    Diabetes management; Health costs; Count data;
    All these keywords.

    JEL classification:

    • I1 - Health, Education, and Welfare - - Health

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