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

Bolin, Kristian LU ; Lindgren, Anna LU ; Lindgren, Björn LU and Lundborg, Petter LU (2009) In International Journal of Health Care Finance and Economics 9(1). p.83-112
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... (More)
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. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Healthcare utilisation, Cross-country analysis, Europe, SHARE, Physician visits
in
International Journal of Health Care Finance and Economics
volume
9
issue
1
pages
83 - 112
publisher
Springer
external identifiers
  • wos:000263419100005
  • pmid:19009344
  • scopus:60849115248
ISSN
1573-6962
DOI
10.1007/s10754-008-9048-9
language
English
LU publication?
yes
id
ed761ec2-65aa-4156-84c4-f0b3dc1de58d (old id 1372195)
alternative location
http://www.ncbi.nlm.nih.gov/pubmed/19009344?dopt=Abstract
date added to LUP
2009-05-08 17:27:17
date last changed
2017-05-28 03:43:34
@article{ed761ec2-65aa-4156-84c4-f0b3dc1de58d,
  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.},
  author       = {Bolin, Kristian and Lindgren, Anna and Lindgren, Björn and Lundborg, Petter},
  issn         = {1573-6962},
  keyword      = {Healthcare utilisation,Cross-country analysis,Europe,SHARE,Physician visits},
  language     = {eng},
  number       = {1},
  pages        = {83--112},
  publisher    = {Springer},
  series       = {International Journal of Health Care Finance and Economics},
  title        = {Utilisation of physician services in the 50+population: the relative importance of individual versus institutional factors in 10 European countries},
  url          = {http://dx.doi.org/10.1007/s10754-008-9048-9},
  volume       = {9},
  year         = {2009},
}