Primary care utilisation and workers’ opportunity costs. Evidence from Italy

This paper analyses the effects of employment condition and work hours on the utilisation of primary care services in Italy. Although the Italian NHS provides free and equitable access to primary care, type of occupation and labour contracts may still deter workers to attend medical appointments. The hypothesis is that the higher the workers’ opportunity cost in terms of earning forgone, the less the demand for General Practitioner (GP) visits. Using survey data provided by the Italian National Institute of Statistics (ISTAT), we estimate a negative binomial model of GP visits as a function of employment related variables, individual characteristics, supply factors and geographical effects. We find that selfemployed workers, managers and cadres have relatively low demand compared to white and blue collars. We conclude that the former, bearing higher opportunity costs, suffer more from the loss of earnings related to the absence from work than the latter.