Eligibility for free GP care and the utilisation of GP services by children in Ireland
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Eligibility for free GP care and the utilisation of GP services by children in Ireland Richard Layte · Anne Nolan
Received: 27 November 2012 / Accepted: 24 November 2014 © Springer Science+Business Media New York 2014
Abstract The majority of the Irish population pay the full out-of-pocket price of a GP visit, with only those on low incomes exempt. While there is an extensive literature analysing the impact of the Irish system of eligibility for free GP care on GP visiting rates among adults, there is a lack of evidence for children. Given the importance of socio-economic health inequalities in shaping the future outcomes of children, it is important to analyse the extent to which the current system of eligibility leads to inequities in access to GP services among Irish children. In addition, some private health insurance plans have started to offer cover for GP expenses, which adds an additional layer of complexity to the existing system of eligibility, and to date, this has not been studied. Using a large, nationally-representative data-set covering two cohorts of Irish children (9-month olds and 9-year olds), we examine the role of eligibility for free GP care in determining GP visiting rates among children. As with the adult population, the results show that, even with controls for child health, and parental and family characteristics, eligibility for free GP care is a significant determinant of GP utilisation among Irish children. Keywords GP services · Children · Utilisation · Economic Incentives · Ireland · Latent class JEL Classification
C20 · D12 · I10
R. Layte · A. Nolan (B) Economic and Social Research Institute, Whitaker Square, Sir John Rogerson’s Quay, Dublin, Ireland e-mail: [email protected] R. Layte Children’s Research Centre, Trinity College, Dublin, Ireland A. Nolan Department of Economics, Trinity College, Dublin, Ireland
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R. Layte, A. Nolan
Introduction Equity of access to health care is regarded as a key objective of national and international health policy. As the first point of contact for most individuals’ interactions with the health service, the role of the general practitioner (GP) is crucial. Previous research on equity in the use of GP services in Ireland has largely concentrated on the adult population (Layte et al. 2009; Layte and Nolan 2004; Madden et al. 2005; Nolan 2007, 2008b, 1991, 1993; O’Reilly et al. 2007; Nolan 2008a), and there has been little research on patterns of GP utilisation among children (an exception is a study by Tussing (1985) in the early 1980s). In light of the finding that inequities in access to health care have significant effects on child health status (Currie 1995; Currie et al. 2008; Currie and Gruber 1996; Lin 2009), and given the strong causal links that have been demonstrated between childhood health and later outcomes (Case et al. 2005), it is particularly important to examine the extent to which the current Irish system of eligibility for free GP care is leading to inequities in access to GP care among Irish children. The Irish system of
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