Utilisation of physician services in the 50+population: the relative importance of individual versus institutional factors in 10 European countries

Kristian Bolin, Anna Lindgren, Björn Lindgren, Petter Lundborg

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15 Citations (SciVal)

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% of the between-country variation in physician visits, while the organisational and cultural factors considered each accounted for about 15% 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% of the between-country variation, whereas individual health differences only accounted for 11% of the variation.
Original languageEnglish
Pages (from-to)83-112
JournalInternational Journal of Health Care Finance and Economics
Volume9
Issue number1
DOIs
Publication statusPublished - 2009

Bibliographical note

The information about affiliations in this record was updated in December 2015.
The record was previously connected to the following departments: Centre for Economic Demography (012019200), Division of Health Economics and Forensic Medicine (Closed 2012) (013040050), Mathematical Statistics (011015003)

Subject classification (UKÄ)

  • Health Care Service and Management, Health Policy and Services and Health Economy

Keywords

  • Healthcare utilisation
  • Cross-country analysis
  • Europe
  • SHARE
  • Physician visits

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