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GP co-payment

Mari Magnussen Landsem, Jon Magnussen
We examine the effect of copayment on the utilization of the GP service in Norway. We use a regression discontinuity design to study two key aspects of the policy. First, we examine the overall effect of copayments on total utilization of the GP service. Second, we look at how this effect varies across different patient groups according to medical necessity. Data consists of 5,5 million GP visits for youths aged 10-20 over the 6 year period 2009-2014. We find that the introduction of a co-payment leads to an overall reduction of GP visits of 10-15%...
March 23, 2018: Social Science & Medicine
E Tierney, M O'Sullivan, L Hickey, A Hannigan, C May, W Cullen, N Kennedy, L Kineen, A MacFarlane
BACKGROUND: Primary care is the cornerstone of healthcare reform with policies across jurisdictions promoting interdisciplinary team working. The effective implementation of such health policies requires understanding the perspectives of all actors. However, there is a lack of research about health professionals' views of this process. This study compares Primary Healthcare Professionals' perceptions of the effectiveness of the Primary Care Strategy and Primary Care Team (PCT) implementation in Ireland...
November 22, 2016: BMC Family Practice
Ellen Keizer, Irene Maassen, Marleen Smits, Michel Wensing, Paul Giesen
BACKGROUND: Out-of-hours primary care services have a high general practitioner (GP) workload with increasing costs, while half of all contacts are non-urgent. OBJECTIVES: To identify views of GPs to influence the use of the out-of-hours GP cooperatives. METHODS: Cross-sectional survey study among a random sample of 800 GPs in the Netherlands. RESULTS: Of the 428 respondents (53.5% response rate), 86.5% confirmed an increase in their workload and 91...
September 2016: European Journal of General Practice
T Sánchez-Sagrado
The poor planning of health care professionals in Spain has led to an exodus of doctors leaving the country. France is one of the chosen countries for Spanish doctors to develop their professional career. The French health care system belongs to the Bismarck model. In this model, health care system is financed jointly by workers and employers through payroll deduction. The right to health care is linked to the job, and provision of services is done by sickness-funds controlled by the Government. Primary care in France is quite different from Spanish primary care...
January 2016: Semergen
Caroline Colton
In 2014, the Australian Capital Territory Civil and Administrative Appeals Tribunal (ACAT) made a finding of professional misconduct against a Canberra general practitioner working in two bulk-billing medical practices established by a corporate medical practice service company, Primary Health Care Limited (Medical Board of Australia v Tausif (Occupational Discipline) [2015] ACAT 4). This column analyses that case, particularly in relation to the ACAT finding that the practitioner's professional misconduct was substantially contributed to by an unsafe system of care, specifically, the failure of Primary Health Care to provide supervision and mentoring for clinicians working at its medical centres...
March 2015: Journal of Law and Medicine
Deepa Sriram, Alexandra McManus, Lynne Emmerton, Moyez Jiwa
BACKGROUND: Large proportion of Australians have access to pharmacists' health advice at no cost. The impact of a proposed co-payment levy for general practitioner (GP) consultation by Australian government is unclear. This raises an interesting question about consumers' perceived value of health-related consultations. OBJECTIVE: This survey of representative sample of Western Australians explores the hypothesis that Australians are willing to pay for advanced model of pharmacy consultation...
July 2015: Research in Social & Administrative Pharmacy: RSAP
J Alasdair Millar, Robyn C Millar
BACKGROUND: The Australian federal government has proposed an AUD $7 patient co-payment for a general practitioner (GP) consultation. One effect of the co-payment may be that patients will seek assistance at public hospital emergency departments (EDs), where currently there is no user charge. AIMS: We studied the possible financial impact of patient diversion on the Western Australia (WA) health budget. METHOD: We constructed a spreadsheet model of changes in annual cash flows including the co-payment, GP fees for service, and rates of diversion to emergency departments with additional marginal costs for ED attendance...
2014: Australasian Medical Journal
Sriskantharajah Arun-Castro
OBJECTIVES & BACKGROUND: To establish whether the need to pay for GP services including consultations, phlebotomy and referrals, affects how households utilise A&E in Jersey. To describe the reasons why households have previously utilised A&E instead of a GP. BACKGROUND: Outside of the NHS, Jersey's primary healthcare service is funded through direct user-fees and co-payments, whilst secondary care including the island's sole Emergency Department is free. The average GP consultation in Jersey costs £37...
September 2014: Emergency Medicine Journal: EMJ
Caroline Colton, Thomas Faunce
The use of commissions of audit as vehicles to drive privatisation policy agendas in areas such as health service delivery has become popular with conservative federal and State governments. Such commissions have characteristically been established early in the terms of such governments with carefully planned terms of reference and membership. The policy directions they advocate, unlike election policies, have not come under the intense scrutiny, wide public debate or the opportunities for (dis)endorsement afforded by the electoral process...
March 2014: Journal of Law and Medicine
Vincenzo Atella, Joanna Aleksandra Kopinska
OBJECTIVES: In this article we investigate the causal effect of cost-sharing schemes on compliance with statins in a quantile regression framework. METHODS: We use the health search CSD-LPD data, a longitudinal observational dataset containing computer-based patient records collected by Italian general practitioners. We exploit a series of natural experiments referring to several introductions of co-payment schemes in some of the Italian regions between 2000 and 2009...
April 2014: International Journal of Public Health
H Philips, R Remmen, P De Paepe, W Buylaert, P Van Royen
INTRODUCTION: In many countries out of hours (OOH) care is offered by different health care services. General practitioners (GP) tend to offer services in competition with emergency departments (ED). Patients behaviour depends on a number of factors. In this study, we highlight the knowledge and ideas of patients concerning the co-payment system. METHODS: We used a mixed methods design, combining quantitative and qualitative research. During two weekends in January 2005, all patients using the ED or the GP OOH service, were invited for an interview with a structured questionnaire...
January 2013: Acta Clinica Belgica
Santosh Jatrana, Peter Crampton
INTRODUCTION: Gender differences in health status and use of health care services have been established in the developed world with less attention paid to gender differences in financial barriers to primary care. Such barriers represent potentially avoidable mortality and morbidity. AIM: To examine gender differences in financial barriers to New Zealand primary health care. METHODS: Data from SoFIE-health, an add-on to Statistics New Zealand-led Survey of Family, Income and Employment (SoFIE), analysed using logistic regression, controlling for demographic, socioeconomic, health behaviour and health variables...
June 2012: Journal of Primary Health Care
Signe S Nielsen, Nana F Hempler, Frans B Waldorff, Svend Kreiner, Allan Krasnik
BACKGROUND: Legislation in Denmark explicitly states the right to equal access to healthcare. Nevertheless, inequities may exist; accordingly evidence is needed. Our objective was to investigate whether differences in healthcare utilisation in immigrants, their descendents, and ethnic Danes could be explained by health status, socioeconomic factors, and integration. METHODS: We conducted a nationwide survey in 2007 with 4952 individuals aged 18-66 comprising ethnic Danes; immigrants from the former Yugoslavia, Iran, Iraq, Lebanon, Pakistan, Somalia, Turkey; and Turkish and Pakistani descendents...
May 2012: Scandinavian Journal of Public Health
Maria-Isabel Farfan-Portet, Carine Van de Voorde, France Vrijens, Robert Vander Stichele
The generic reference price system (RPS) can impose a financial penalty for patients using a brand name drug instead of its generic alternative. Previous studies on the impact of the RPS have not considered the potentially differential effect of using generic alternatives for individuals with a different socioeconomic background. However, patients' characteristics might determine their overall knowledge of the existence of the system and thus of the financial burden to which they may be confronted. The association between patients' characteristics and the use of generic drugs versus brand name drugs was analyzed for ten highly prescribed pharmaceutical molecules included in the Belgian generic reference price system...
June 2012: European Journal of Health Economics: HEPAC: Health Economics in Prevention and Care
France Vrijens, Carine Van de Voorde, Maria-Isabel Farfan-Portet, Robert Vander Stichele
Reference pricing is a common cost-sharing mechanism, with the financial penalty for the use of costly drugs shifted from the third-party payer to the patient. Unintended distributional consequences might arise, if the weakest socioeconomic groups face a relatively higher financial burden. This study analyzed for a sample of Belgian individual prescription data for 4 clusters of commonly used drugs (proton pump inhibitors, statins and two groups of antihypertensives [drugs acting on renin-angiotensin system and dihydropyridine derivatives]) whether the probability to receive the least expensive molecule within a cluster was linked to the socioeconomic status of the patient...
June 2012: European Journal of Health Economics: HEPAC: Health Economics in Prevention and Care
Daniel Pinto, M Clare Robertson, Paul Hansen, J Haxby Abbott
BACKGROUND: Estimating costs is essential to the economic analysis of health care programs. Health care costs are often captured from administrative databases or by patient report. Administrative records only provide a partial representation of health care costs and have additional limitations. Patient-completed questionnaires may allow a broader representation of health care costs; however the validity and feasibility of such methods have not been firmly established. This study was conducted to assess the validity and feasibility of using a patient-completed questionnaire to capture health care use and costs for patients with osteoarthritis, and to compare the research costs of the data-capture methods...
2011: BMC Medical Research Methodology
Leah S Steele, Richard H Glazier, Mohammad Agha, Rahim Moineddin
BACKGROUND: In Ontario, psychiatric care is fully covered by provincial health insurance without co-payments or deductibles. The provincial fee schedule supports a "gatekeeper" system for psychiatric care by paying psychiatrists more for consultations with patients who have a physician referral. In this context, we sought to explore socio-economic differences in patterns of mental health service delivery. METHOD: We employed a retrospective cohort design using administrative and census data from 1995 to 2004...
May 2009: Healthcare Policy, Politiques de Santé
Jochen Schmitt, Wilhelm Kirch, Michael Meurer
BACKGROUND: The introduction of a co-payment of 10 Euros per quarter and physician for adults (the so called "Praxisgebühr") as of January 01, 2004 was a significant health policy measure with unknown effects on medical care of patients with atopic eczema (AE). METHODS: Analysis of an administrative healthcare database from Saxony, Germany. Comparison of outpatient care and treatment of 11,036 patients with AE (6,696 adults) in the year before (2003) and after (2004) the introduction of the co-payment using descriptive statistics and logistic regression modeling...
October 2009: Journal der Deutschen Dermatologischen Gesellschaft, Journal of the German Society of Dermatology: JDDG
Dermot O'Reilly, Ciaran O'Neill, Tom O'Dowd, Karen Galway, Andrew Gilliland, Alan Kelly, Andrew Murphy, Ethna Shryane, Keith Steele, Gerry Bury
OBJECTIVES: Most Organisation for Economic Co-operation and Development (OECD) countries have introduced cost-sharing. This study compares the views of patients who are used to a service that is free at the point of delivery with those who are used to a system where 70% of patients pay for consultations. METHODS: Secondary analysis of survey data from a random sample of 11,870 patients in Northern Ireland and the Republic of Ireland. RESULTS: A 52% response rate was achieved, though respondents were representative of the two populations...
October 2007: Journal of Health Services Research & Policy
G Brenner, H Koch, H Kerek-Bodden, J Heuer, A Lang, A Lang
Health service research needs coded diagnoses of outpatients. The morbidity treated by physicians in ambulatory care is analysed every quarter on the basis of the diagnoses of about 1,2 Mio. patients by a randomised panel. Patient data combined with diagnoses, encounters and procedures demonstrate the variety of medical care provided. Relevant research questions are for instance the influence of co-payment on the structure of diagnoses or the prevalence of heart diseases in the offices of general practitioners...
August 2007: Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz
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