GP reimbursement and visiting behaviour in Ireland

David Madden (), Brian Nolan and Anne Nolan

No 200426, Working Papers from School of Economics, University College Dublin

Abstract: In Ireland, approximately 30 per cent of the population (“medical cardholders”) receive free GP services while the remainder (“non-medical cardholders”) must pay for each visit. In 1989, the manner in which GPs were reimbursed by the State for their medical cardholder patients was changed from fee-for-service to capitation while other patients continued to pay on a fee-for-service basis. Concerns about supplier-induced demand were in part responsible for this policy change. The purpose of this paper is to examine the extent to which the utilisation of GP services is influenced by the reimbursement system facing GPs, by comparing visiting rates for the two groups before and after this change. Using a difference-in-differences approach on pooled micro-data from 1987, 1995 and 2000, we find that medical card eligibility exerts a consistently positive and significant effect on the utilisation of GP services. However, the differential in visiting rates between medical cardholders and others did not narrow between 1987 and 1995 or 2000, as might have been anticipated if supplier-induced demand played a major role prior to the change in reimbursement system.

Keywords: GP utilisation; Reimbursement; Supplier-induced demand; Difference-in-differences; Physician services utilization--Ireland; Medical policy--Ireland; Medical fees--Ireland (search for similar items in EconPapers)
Date: 2004-12
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Citations: View citations in EconPapers (3)

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http://hdl.handle.net/10197/795 First version, 2004 (application/pdf)

Related works:
Journal Article: GP reimbursement and visiting behaviour in Ireland (2005)
Working Paper: GP Reimbursement and Visiting Behaviour in Ireland (2004)
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Persistent link: https://EconPapers.repec.org/RePEc:ucn:wpaper:200426

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