Self-rated health and endogenous selection into primary care

Area of Science:

• Health Services Research
• Public Health
• Econometrics

Background:

• Understanding the impact of primary care is crucial for health policy.
• Self-reported health status is a key indicator of population well-being.
• Selection bias in healthcare utilization can confound results.

Purpose of the Study:

• To determine the causal effect of primary care utilization on subjective health status in Turkey.
• To address endogeneity in healthcare seeking behavior.
• To validate the use of self-rated health as a reliable health outcome measure.

Main Methods:

• Utilized individual-level data from the 2012 Turkish Health Research Survey.
• Employed recursive bivariate ordered probit models to account for selection bias.
• Controlled for sociodemographic, socioeconomic, behavioral, and access factors.

Main Results:

• Primary care utilization was found to be endogenously determined.
• Significant positive causal effect of primary care utilization on self-rated health was observed.
• Findings remained robust when using objective health measures and specific care types.

Conclusions:

• Primary care utilization causally improves subjective health status in the Turkish population.
• The study validates the use of self-rated health and preventive care utilization measures.
• Results support policies promoting primary care access and utilization.