GP reimbursement and visiting behaviour in Ireland

Area of Science:

• Health Economics
• Public Health Policy
• General Practice Services

Background:

• In Ireland, a significant portion of the population receives free GP services (medical card patients), while others pay privately.
• A key policy change in 1989 altered the reimbursement method for GPs serving medical card patients from fee-for-service to capitation.
• This policy shift was partly motivated by concerns regarding supplier-induced demand in healthcare provision.

Purpose of the Study:

• To investigate the impact of GP reimbursement systems on the utilization of general practitioner services.
• To compare patient visiting rates before and after the 1989 reimbursement policy change in Ireland.

Main Methods:

• Utilized a difference-in-differences analysis.
• Employed pooled micro-data from survey years 1987, 1995, and 2000.
• Compared utilization rates between medical card patients and private patients.

Main Results:

• Medical card eligibility demonstrated a consistent and significant positive effect on GP service utilization.
• The study found no significant narrowing of the visiting rate differential between medical card and private patients post-reimbursement change.
• These findings suggest that supplier-induced demand may not have been a dominant factor influencing utilization prior to the policy alteration.

Conclusions:

• The reimbursement system for GPs influences patient utilization of services.
• The 1989 policy change did not alter the pre-existing disparity in visiting rates between publicly funded and privately funded patients.
• Further research is needed to fully understand the dynamics of supplier-induced demand in relation to GP reimbursement models.