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

Pavlina Zilova () and Jana Votapkova (Prochazkova) ()
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Pavlina Zilova: Institute of Economic Studies, Faculty of Social Sciences, Charles University, Prague, Czech Republic, http://ies.fsv.cuni.cz/

No 2012/30, Working Papers IES from Charles University Prague, Faculty of Social Sciences, Institute of Economic Studies

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.

Keywords: co-payments; outpatient care; Czech Republic; natural experiment; Zero-inflated negative binomial (ZINB) model; Multinomial logit (MNL) model (search for similar items in EconPapers)
JEL-codes: D04 I18 (search for similar items in EconPapers)
Pages: 23pages
Date: 2012-11, Revised 2012-11
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