Access to primary care and workers’ opportunity costs. Evidence from Italy

This paper explores whether and to which extent employment condition and working hours influence individuals’ decision process in consuming primary care. The hypothesis is that the higher the workers’ opportunity cost in terms of earning forgone, the less the demand for General Practitioner (GP) visits. Data used in the analysis come from the 2004/2005 “Health conditions and recourse to health services” survey provided by the Italian National Institute of Statistics (ISTAT). We apply a negative binomial regression to model the relationship between the number of GP visits and employment related variables, controlling for a rich set of individual demographic characteristics, socio-economic variables, health status, supply and geographical factors. We show that self-employed workers, managers and cadres use significantly less primary care services notwithstanding the access is free. We interpret these findings as being due to the fact that these type of workers have higher opportunity costs than white and blue collars, since they suffer more from the loss of earnings related to the absence from work