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The Effect of the Abolition of User Charges on the Demand for Ambulatory Doctor Visits

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Abstract

The paper estimates the effect of the abolition of user charges for outpatient care (30 CZK/1.2 EUR) in 2009 on the demand for ambulatory doctor visits in the Czech Republic. The reform applied only to children, which enabled us to take the difference-in-differences approach. Children constitute a treatment group, whereas adults serve as a control group. Besides the treatment effect, we control also for a number of personal characteristics using a micro-level data (EU-SILC). We estimate two models: Multinomial logit (MNL) and Zero-inflated negative binomial (ZINB). The effect of the abolition of user charges on the number of doctor visits proved insignificant suggesting that either the demand for this type of care is indeed inelastic, user charges were set too low or the people have not changed their behavior yet. On the contrary, we found that personal income, the number of household members and sex significantly influence the number of visits to the doctor. Two robustness checks using restricted samples confirms the results.

Suggested Citation

  • Pavlina Zilova & Jana Votapkova, 2012. "The Effect of the Abolition of User Charges on the Demand for Ambulatory Doctor Visits," Working Papers IES 2012/30, Charles University Prague, Faculty of Social Sciences, Institute of Economic Studies, revised Nov 2012.
    • Handle: RePEc:fau:wpaper:wp2012_30
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    File URL: http://ies.fsv.cuni.cz/sci/publication/show/id/4783
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    Keywords

    co-payments; outpatient care; Czech Republic; natural experiment; Zero-inflated negative binomial (ZINB) model; Multinomial logit (MNL) model;
    All these keywords.

    JEL classification:

    • D04 - Microeconomics - - General - - - Microeconomic Policy: Formulation; Implementation; Evaluation
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health

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