IDEAS home Printed from https://ideas.repec.org/p/esr/wpaper/hrb01.html
   My bibliography  Save this paper

A Cross-Sectional Analysis of the Utilisation of GP Services in Ireland: 1987-2001

Author

Listed:
  • Nolan, Anne

    (Economic and Social Research Institute (ESRI))

  • Nolan, Brian

    (Economic and Social Research Institute (ESRI))

Abstract

This paper examines the determinants of general practitioner (GP) utilisation patterns in Ireland over the period 1987-2001. Using three different micro-data sets, the influence of socio-economic factors as well as health status variables on the demand for GP visits is analysed. A particular focus of this paper is an examination of the impact of economic incentives as represented by medical card eligibility. While medical cardholders are entitled to free GP consultations, nonmedical cardholders must pay for each visit. In addition, it is important to analyse the impact of the 1989 change in the reimbursement system for GPs with medical cardholder patients from fee for service to capitation. A variety of cross-sectional econometric methodologies are considered with the two-step hurdle negative binomial model found to be the most appropriate. The empirical results confirm the results of earlier studies about the effects of socio-economic characteristics such as age, sex and income on GP utilisation patterns and also confirm the highly significant effects of health status. While medical card eligibility is consistently positive and significant across the years of our analysis (1987, 1995, 2000, 2001), there is no evidence to show that this effect diminished in importance between 1987 and 1995.

Suggested Citation

  • Nolan, Anne & Nolan, Brian, 2003. "A Cross-Sectional Analysis of the Utilisation of GP Services in Ireland: 1987-2001," Papers HRBWP01, Economic and Social Research Institute (ESRI).
    • Handle: RePEc:esr:wpaper:hrb01
    Note: Published by ESRI, ISSC & University of Ulster
    as

    Download full text from publisher

    File URL: https://www.esri.ie/pubs/HRBWP01.pdf
    Download Restriction: no
    ---><---

    References listed on IDEAS

    as
    1. Martin Schellhorn, 2001. "The effect of variable health insurance deductibles on the demand for physician visits," Health Economics, John Wiley & Sons, Ltd., vol. 10(5), pages 441-456, July.
    2. Chiappori, Pierre-Andre & Durand, Franck & Geoffard, Pierre-Yves, 1998. "Moral hazard and the demand for physician services: First lessons from a French natural experiment," European Economic Review, Elsevier, vol. 42(3-5), pages 499-511, May.
    3. Ulf‐ G. Gerdtham, 1997. "Equity in Health Care Utilization: Further Tests Based on Hurdle Models and Swedish Micro Data," Health Economics, John Wiley & Sons, Ltd., vol. 6(3), pages 303-319, May.
    4. Thomas C. Buchmueller & Agnès Couffinhal & Michel Grignon & Marc Perronnin, 2004. "Access to physician services: does supplemental insurance matter? Evidence from France," Health Economics, John Wiley & Sons, Ltd., vol. 13(7), pages 669-687, July.
    5. Ángel Marcos Vera‐Hernández, 1999. "Duplicate coverage and demand for health care. The case of Catalonia," Health Economics, John Wiley & Sons, Ltd., vol. 8(7), pages 579-598, November.
    6. Rainer Winkelmann, 2004. "Health care reform and the number of doctor visits-an econometric analysis," Journal of Applied Econometrics, John Wiley & Sons, Ltd., vol. 19(4), pages 455-472.
    7. Tussing, A. Dale, 1985. "Irish Medical Care Resources: An Economic Analysis," Research Series, Economic and Social Research Institute (ESRI), number GRS126.
    8. Sergi Jiménez‐Martín & José M. Labeaga & Maite Martínez‐Granado, 2002. "Latent class versus two‐part models in the demand for physician services across the European Union," Health Economics, John Wiley & Sons, Ltd., vol. 11(4), pages 301-321, June.
    9. 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.
    10. Holly, Alberto & Gardiol, Lucien & Domenighetti, Gianfranco & Brigitte Bisig, 1998. "An econometric model of health care utilization and health insurance in Switzerland," European Economic Review, Elsevier, vol. 42(3-5), pages 513-522, May.
    11. Unto Häkkinen & Gunnar Rosenqvist & Seppo Aro, 1996. "Economic depression and the use of physician services in Finland," Health Economics, John Wiley & Sons, Ltd., vol. 5(5), pages 421-434, September.
    12. Hugh R. Waters, 1999. "Measuring the impact of health insurance with a correction for selection bias-a case study of Ecuador," Health Economics, John Wiley & Sons, Ltd., vol. 8(5), pages 473-483.
    13. A. C. Cameron & P. K. Trivedi & Frank Milne & J. Piggott, 1988. "A Microeconometric Model of the Demand for Health Care and Health Insurance in Australia," The Review of Economic Studies, Review of Economic Studies Ltd, vol. 55(1), pages 85-106.
    14. Hurd, Michael D. & McGarry, Kathleen, 1997. "Medical insurance and the use of health care services by the elderly," Journal of Health Economics, Elsevier, vol. 16(2), pages 129-154, April.
    15. Nolan, Brian, 1991. "The Utilisation and Financing of Health Services in Ireland," Research Series, Economic and Social Research Institute (ESRI), number GRS155.
    16. J Durkan; & C Harmon; & J Hughes, 1996. "Health Services Utilisation in the UK. An Empirical Analysis Using Microdata," Economics Department Working Paper Series n650796, Department of Economics, National University of Ireland - Maynooth.
    17. Nolan, Brian, 1993. "Economic incentives, health status and health services utilisation," Journal of Health Economics, Elsevier, vol. 12(2), pages 151-169, July.
    18. Colm Harmon & Brian Nolan, 2001. "Health insurance and health services utilization in Ireland," Health Economics, John Wiley & Sons, Ltd., vol. 10(2), pages 135-145, March.
    19. Santos Silva, Joao M. C. & Windmeijer, Frank, 2001. "Two-part multiple spell models for health care demand," Journal of Econometrics, Elsevier, vol. 104(1), pages 67-89, August.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Jacqueline O'Reilly & Miriam M. Wiley, 2007. "The Public/Private Mix in Irish Acute Public Hospitals: Trends and Implications," Papers WP218, Economic and Social Research Institute (ESRI).
    2. Nolan, Anne & Nolan, Brian, 2007. "Income, Medical Card Eligibility and Access to GP Services in Ireland," Book Chapters, in: Nolan, Brian (ed.),The Provision and Use of Health Services, Health Inequalities and Health and Social Gain, Economic and Social Research Institute (ESRI).
    3. Garrett, Shane & Mathieu, Catherine & Nolan, Anne & Nolan, Brian & Sterdyniak, Henri, 2004. "Budget Perspectives 2005," Research Series, Economic and Social Research Institute (ESRI), number BMI176 edited by Callan, Tim & Doris, Aedin & McCoy, Daniel.
    4. Nolan, Anne & Nolan, Brian, 2004. "Ireland's Health Care System: Some Issues and Challenges," Papers HRBWP14, Economic and Social Research Institute (ESRI).
    5. Pat McGregor & Pat McKee & Ciaran O’Neill, 2006. "GP Utilisation in Northern Ireland - Exploiting the Gatekeeper Function," The Economic and Social Review, Economic and Social Studies, vol. 37(1), pages 71-90.
    6. Smith, Samantha, 2007. "Emergency Department Utilisation in Four Irish Teaching Hospitals," Papers HRBWP26, Economic and Social Research Institute (ESRI).
    7. Callan, Tim & Nolan, Brian, 2004. "Relative Income Poverty: Learning from the Best-Performing Countries," Papers BP2005/2, Economic and Social Research Institute (ESRI).
    8. McGregor, P. & Nolan, Anne & Nolan, Brian & O'Neill, C., 2006. "A Comparison of GP Visiting in Northern Ireland and the Republic of Ireland," Papers HRBWP22, Economic and Social Research Institute (ESRI).
    9. Nolan, Anne & Nolan, Brian, 2004. "A Panel Data Analysis of The Utilisation of GP Services in Ireland: 1995-2001," Papers HRBWP13, Economic and Social Research Institute (ESRI).

    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. Nolan, Anne & Nolan, Brian, 2004. "A Panel Data Analysis of The Utilisation of GP Services in Ireland: 1995-2001," Papers HRBWP13, Economic and Social Research Institute (ESRI).
    2. 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.
    3. David Madden & Anne Nolan & Brian Nolan, 2005. "GP reimbursement and visiting behaviour in Ireland," Health Economics, John Wiley & Sons, Ltd., vol. 14(10), pages 1047-1060, October.
    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. Nolan, Anne & Nolan, Brian, 2007. "Income, Medical Card Eligibility and Access to GP Services in Ireland," Book Chapters, in: Nolan, Brian (ed.),The Provision and Use of Health Services, Health Inequalities and Health and Social Gain, Economic and Social Research Institute (ESRI).
    6. Erik Schokkaert & Tom Van Ourti & Diana De Graeve & Ann Lecluyse & Carine Van de Voorde, 2010. "Supplemental health insurance and equality of access in Belgium," Health Economics, John Wiley & Sons, Ltd., vol. 19(4), pages 377-395, April.
    7. Layte, Richard & Nolan, Anne, 2013. "Income-Related Inequity in the Use of GP Services: A Comparison of Ireland and Scotland," Papers WP454, Economic and Social Research Institute (ESRI).
    8. Anne Nolan, 2007. "A dynamic analysis of GP visiting in Ireland: 1995–2001," Health Economics, John Wiley & Sons, Ltd., vol. 16(2), pages 129-143, February.
    9. 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.
    10. Bolhaar, Jonneke & Lindeboom, Maarten & van der Klaauw, Bas, 2012. "A dynamic analysis of the demand for health insurance and health care," European Economic Review, Elsevier, vol. 56(4), pages 669-690.
    11. Thomas C. Buchmueller & Agnès Couffinhal & Michel Grignon & Marc Perronnin, 2004. "Access to physician services: does supplemental insurance matter? Evidence from France," Health Economics, John Wiley & Sons, Ltd., vol. 13(7), pages 669-687, July.
    12. Dardanoni, Valentino & Li Donni, Paolo, 2012. "Incentive and selection effects of Medigap insurance on inpatient care," Journal of Health Economics, Elsevier, vol. 31(3), pages 457-470.
    13. Teresa Bago d'Uva, 2006. "Latent class models for utilisation of health care," Health Economics, John Wiley & Sons, Ltd., vol. 15(4), pages 329-343, April.
    14. Barros, Pedro Pita & Machado, Matilde P. & Sanz-de-Galdeano, Anna, 2008. "Moral hazard and the demand for health services: A matching estimator approach," Journal of Health Economics, Elsevier, vol. 27(4), pages 1006-1025, July.
    15. Perronnin, Marc, 2013. "Effet de l'assurance complémentaire santé sur les consommations médicales, entre risque moral et amélioration de l'accès aux soins," Economics Thesis from University Paris Dauphine, Paris Dauphine University, number 123456789/13659 edited by Wittwer, Jérôme.
    16. Antonio Clavero Barranquero & Mª. Luz González Alvarez, 2005. "A survey of econometric models to analyze the demand and utilisation of health care," Hacienda Pública Española / Review of Public Economics, IEF, vol. 173(2), pages 129-162, June.
    17. Astrid Kiil, 2012. "Does employment-based private health insurance increase the use of covered health care services? A matching estimator approach," International Journal of Health Economics and Management, Springer, vol. 12(1), pages 1-38, March.
    18. Astrid Kiil & Jacob Nielsen Arendt, 2017. "The effect of complementary private health insurance on the use of health care services," International Journal of Health Economics and Management, Springer, vol. 17(1), pages 1-27, March.
    19. Budi Hidayat & Subhash Pokhrel, 2009. "The Selection of an Appropriate Count Data Model for Modelling Health Insurance and Health Care Demand: Case of Indonesia," IJERPH, MDPI, vol. 7(1), pages 1-19, December.
    20. Omar Paccagnella & Vincenzo Rebba & Guglielmo Weber, 2013. "VOLUNTARY PRIVATE HEALTH INSURANCE AMONG THE OVER 50s IN EUROPE," Health Economics, John Wiley & Sons, Ltd., vol. 22(3), pages 289-315, March.

    More about this item

    Keywords

    hrb;

    Statistics

    Access and download statistics

    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:esr:wpaper:hrb01. 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: Sarah Burns (email available below). General contact details of provider: https://edirc.repec.org/data/esriiie.html .

    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.