Format

Send to

Choose Destination
Eur J Health Econ. 2019 Aug 10. doi: 10.1007/s10198-019-01095-6. [Epub ahead of print]

Effects of primary care cost-sharing among young adults: varying impact across income groups and gender.

Author information

1
Health Metrics, Sahlgrenska Academy at University of Gothenburg, PO Box 463, 405 30, Gothenburg, Sweden. naimi.johansson@gu.se.
2
Department of Economics, Karlstad University, Universitetsgatan 2, 651 88, Karlstad, Sweden.
3
Norwegian Social Research (NOVA), Oslo, Norway.
4
Health Metrics, Sahlgrenska Academy at University of Gothenburg, PO Box 463, 405 30, Gothenburg, Sweden.

Abstract

We estimate the price sensitivity in health care among adolescents and young adults, and assess how it varies across income groups and gender, using a regression discontinuity design. We use the age differential cost-sharing in Swedish primary care as our identification strategy. At the 20th birthday, the copayment increases from €0 to approx. €10 per primary care physician visit and close to this threshold the copayment faced by each person is distributed almost as good as if randomized. The analysis is performed using high-quality health care and economic register data of 73,000 individuals aged 18-22. Our results show that the copayment decreases the average number of visits by 7%. Among women visits are reduced by 9%, for low-income individuals by 11%, and for low-income women by 14%. In conclusion, modest copayments have significant utilization effects, and even in a policy context with relatively low income inequalities, the effect is substantially larger in low-income groups and among women.

KEYWORDS:

Health care demand; Income inequality; Patient cost-sharing; Price sensitivity

PMID:
31401700
DOI:
10.1007/s10198-019-01095-6

Supplemental Content

Full text links

Icon for Springer
Loading ...
Support Center