Utilisation of Physician Services in the 50+ Population. The Relative Importance of Individual versus Institutional Factors in 10 European Countries

Kristian Bolin, Anna Lindgren, Bjorn Lindgren and Petter Lundborg

No 14096, NBER Working Papers from National Bureau of Economic Research, Inc

Abstract: We analysed the relative importance of individual versus institutional factors in explaining variations in the utilisation of physician services among the 50+ in ten European countries. The importance of the latter was investigated, distinguishing between organisational (explicit) and cultural (implicit) institutional factors, by analysing the influence of supply side factors, such as physician density and physician reimbursement, and demand side factors, such as co-payment and gate-keeping, while controlling for a number of individual characteristics, using cross-national individual-level data from SHARE. Individual differences in health status accounted for about 50 percent of the between-country variation in physician visits, while the organisational and cultural factors considered each account for about 15 percent of the variation. The organisational variables showed the expected signs, with higher physician density being associated with more visits and higher co-payment, gate-keeping, and salary reimbursement being associated with less visits. When analysing specialist visits separately, however, organisational and cultural factors played a greater role, each accounting for about 30 percent of the between-country variation, whereas individual health differences only accounted for 1 percent of the variation.

JEL-codes: I11 (search for similar items in EconPapers)
Date: 2008-06
New Economics Papers: this item is included in nep-eec and nep-hea
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Published as Kristian Bolin & Anna Lindgren & Björn Lindgren & Petter Lundborg, 2009. "Utilisation of physician services in the 50+ population: the relative importance of individual versus institutional factors in 10 European countries," International Journal of Health Care Finance and Economics, vol 9(1), pages 83-112.

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