EconPapers    
Economics at your fingertips  
 

Why do patients prefer hospital emergency visits? A nested multinomial logit analysis for patient‐initiated contacts

Jaume Puig‐Junoy (), Marc Saez and Esther Martínez‐García ()
Authors registered in the RePEc Author Service: Esther Martinez-Garcia ()

Health Care Management Science, 1998, vol. 1, issue 1, 39-52

Abstract: This paper analyzes the nature of health care provider choice in the case of patient‐initiated contacts, with special reference to a National Health Service setting, where monetary prices are zero and general practitioners act as gatekeepers to publicly financed specialized care. We focus our attention on the factors that may explain the continuously increasing use of hospital emergency visits as opposed to other provider alternatives. An extended version of a discrete choice model of demand for patient‐initiated contacts is presented, allowing for individual and town residence size differences in perceived quality (preferences) between alternative providers and including travel and waiting time as non‐monetary costs. Results of a nested multinomial logit model of provider choice are presented. Individual choice between alternatives considers, in a repeated nested structure, self‐care, primary care, hospital and clinic emergency services. Welfare implications and income effects are analyzed by computing compensating variations, and by simulating the effects of user fees by levels of income. Results indicate that compensating variation per visit is higher than the direct marginal cost of emergency visits, and consequently, emergency visits do not appear as an inefficient alternative even for non‐urgent conditions. Copyright Kluwer Academic Publishers 1998

Keywords: health care demand; emergency visits; nested multinomial logit; compensating variation; time costs (search for similar items in EconPapers)
Date: 1998
References: Add references at CitEc
Citations: View citations in EconPapers (15) Track citations by RSS feed

Downloads: (external link)
http://hdl.handle.net/10.1023/A:1019082232606 (text/html)
Access to full text is restricted to subscribers.

Related works:
This item may be available elsewhere in EconPapers: Search for items with the same title.

Export reference: BibTeX RIS (EndNote, ProCite, RefMan) HTML/Text

Persistent link: https://EconPapers.repec.org/RePEc:kap:hcarem:v:1:y:1998:i:1:p:39-52

Ordering information: This journal article can be ordered from
http://www.springer.com/journal/10729

DOI: 10.1023/A:1019082232606

Access Statistics for this article

Health Care Management Science is currently edited by Yasar Ozcan

More articles in Health Care Management Science from Springer
Bibliographic data for series maintained by Sonal Shukla () and Springer Nature Abstracting and Indexing ().

 
Page updated 2022-07-25
Handle: RePEc:kap:hcarem:v:1:y:1998:i:1:p:39-52