Time prices and the demand for GP services

Janssen, Richard

doi:10.1016/0277-9536(92)90359-x

Cited by 21 publications

(12 citation statements)

References 17 publications

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“…This same author also asserts that in the case of hurdle models the truncated population is of interest in itself, therefore it is natural to estimate the model for positives by specifying the unobserved heterogeneity in the population induced by the sampling scheme, thus using specification (4). In this paper, we estimated models with c ¼ 2 and 3.…”

Section: Econometric Speci¢cationmentioning

confidence: 99%

“…As shown by several authors [1,2,4,11,19], both categories of time-costs are a factor that shifts the demand for medical care. This assertion is particularly true in health systems where the money price is relatively unimportant, and times costs emerge naturally as a device to allocate resources [1,12].…”

Section: Time Costsmentioning

confidence: 99%

“…Utilization related studies generally have found that male individuals seek less ambulatory care [1,4,6,35]. Furthermore, Oliveira and Bevan [28], reporting to the hospital utilization in Portugal, found that male users present lower levels of utilization but a more complex case-mix.…”

Section: Socioeconomic Variablesmentioning

confidence: 99%

“…Despite the theoretical and empirical interest in this issue [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15], only a few authors in Portugal have tested the impact of time costs on the medical care utilization, mainly on hospital care [14]. This paper provides evidence on this matter describing the results of an empirical analysis of the responses of GP visits to time costs in health centres.…”

Section: Introductionmentioning

confidence: 99%

“…In addition, the health reasons that drive the demand for primary health care are totally different from those related to hospital care, therefore precluding the direct extrapolation of the results obtained in these studies to the Portuguese GP demand. Concerning the studies dealing with the effects of physical waiting in the utilization of medical services [1][2][3][4][5][6]19,20] it is also difficult to extrapolate their findings to the demand of GP services. Besides being a little outdated, almost all these studies analyse medical care categories different from those examined in this paper, and more important, in health systems with different organizations.…”

Section: Introductionmentioning

confidence: 99%

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Utilization of public health centres in Portugal: effect of time costs and other determinants. Finite mixture models applied to truncated samples

Lourenço¹,

Ferreira²

2005

Health Economics

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SummaryThe impact of time costs on the utilization of medical care has been a subject of theoretical and empirical research since the early 1970s.The main goal of this paper is to show the effect of time costs on the number of visits to general practitioners (GP) in Portuguese public health centres. We measured the elasticity of primary health care utilization relative to the total time spent in the health centre and relative to travel time. We also provided evidence regarding the impact of an appointment delay on the utilization of public GP services.Our data resulted from the application of an endogenous sampling scheme, resulting in a truncated-at-zero data set. To model our dependent variable, number of visits, and accounting for the truncated nature of the data we used a finite mixture model specification.The data were obtained from the most recent implementation in Portugal of the 2003/2004 Europep Survey. The two-component negative binomial II finite mixture model led to the identification of two different latent classes of health centre users: a low-users class that comprises 88% of patients with an estimated utilization mean of 4.3 GP visits per year and a frequent-users class with an estimated utilization mean of 11.1 visits for the remaining 12% of the population.We failed to find any statistically significant elasticity of time cost utilization, when this variable is measured as the total time spent in the health centre. Regarding the effect of an appointment delay on health centre utilization we concluded that individuals respond to this variable by lowering the number of GP visits. This last finding may have policy implications, which will be discussed at the end of the paper.

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Section: Econometric Speci¢cationmentioning

confidence: 99%

Section: Time Costsmentioning

confidence: 99%

Section: Socioeconomic Variablesmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Utilization of public health centres in Portugal: effect of time costs and other determinants. Finite mixture models applied to truncated samples

Lourenço¹,

Ferreira²

2005

Health Economics

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Private versus social opportunity cost of time: Valuing time in the demand for health care

1994

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In this paper we examine whether the current method of valuing time within economic appraisals is appropriate. The cost to society of time taken to use health care may differ from the private opportunity cost of such time. However, demand for health care may be affected by the private opportunity time cost and not by the value of time to society. In this paper we show that the private opportunity cost of time is a better predictor of demand for a screening service than the societal approach. It is important, therefore, to use the private opportunity cost of time when assessing the demand for, and impact of, a health care intervention.

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Is general practitioner decision making associated with patient socio-economic status?

Scott

Shiell²,

King³

1996

Social Science & Medicine

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Time prices and the demand for GP services

Cited by 21 publications

References 17 publications

Utilization of public health centres in Portugal: effect of time costs and other determinants. Finite mixture models applied to truncated samples

Utilization of public health centres in Portugal: effect of time costs and other determinants. Finite mixture models applied to truncated samples

Private versus social opportunity cost of time: Valuing time in the demand for health care

Is general practitioner decision making associated with patient socio-economic status?

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