Psychological Barriers for Take-Up of Health Care Benefits and Child Support Benefits in the Netherlands

Abstract

We empirically test an integral model for healthcare and child support benefits take-up using a probability sample of the Dutch population (N = 905). To examine how different psychological factors, in conjunction, explain take-up, we apply model averaging with Akaike’s Information Criterion (AICC). For both types of benefits, people’s perceptions of eligibility best explain take-up. For healthcare benefits, take-up also relates to perceptions of need. Exploratory analyses suggest that for healthcare benefits but not for child support benefits, executive functions, self-efficacy, fear of reclaims, financial stress, and welfare stigma may indirectly explain take-up, with perceived eligibility as mediator. We find no support for knowledge, support, and administrative burden as explanatory factors in take-up. We discuss the results in relation to the Capability Opportunity Motivation Behavior (COM-B) model for developing behavioural change interventions.