Did Adolescents in Norway Respond to the Elimination of Co-payments for General Practitioner Services (original) (raw)

The Effect of Copayments on Children’s and Adolescents’ Use of Medical Care

2015

We exploit a policy change in Sweden to estimate the effect of cost-sharing on the demand for children’s and adolescents’ use of medical care. To this end, we use a large population-wide registry data set including detailed information about individuals and their contacts with the health care system. The reform we study was unexpected and came into effect in January 2002. It abolished copayments in outpatient care for children between 7 and 19 years. We estimate a difference-in-differences model using age groups slightly younger and slightly older as controls. When care became free of charge, we find that individuals increased their number of visits to a doctor by 5-10 percent. Effects are similar across age groups but vary substantially by income, with children from lowincome families being three times as responsive as their more advantaged peers. We also exploit the fact that copayments charged changed discontinuously at age 7 before the reform and at age 20 after the reform. Esti...

Impact of removing prescription co-payments on the use of costly health services: a pragmatic randomised controlled trial

BMC Health Services Research

Objectives To determine whether exempting people (with high health needs and living in areas of high deprivation) from a 5prescriptionchargereduceshospitaluse.DesignTwo−groupparallelprospectiverandomisedcontrolledtrial.SettingPeoplelivinginthecommunityinvariousregionsofNewZealand.ParticipantsOnethousandsixtyonepeoplewholivedinareasofhighsocioeconomicdeprivation,andeithertookmedicinesfordiabetes,tookantipsychoticmedicines,orhadchronicobstructivepulmonarydisease(COPD).Ofthe1053whocompletedthestudy,justunderhalf(495 prescription charge reduces hospital use. Design Two-group parallel prospective randomised controlled trial. Setting People living in the community in various regions of New Zealand. Participants One thousand sixty one people who lived in areas of high socioeconomic deprivation, and either took medicines for diabetes, took antipsychotic medicines, or had chronic obstructive pulmonary disease (COPD). Of the 1053 who completed the study, just under half (49%) were Māori. Interventions Participants were individually randomized (1–1 ratio) to either be exempted from the standard 5prescriptionchargereduceshospitaluse.DesignTwo−groupparallelprospectiverandomisedcontrolledtrial.SettingPeoplelivinginthecommunityinvariousregionsofNewZealand.ParticipantsOnethousandsixtyonepeoplewholivedinareasofhighsocioeconomicdeprivation,andeithertookmedicinesfordiabetes,tookantipsychoticmedicines,orhadchronicobstructivepulmonarydisease(COPD).Ofthe1053whocompletedthestudy,justunderhalf(495 charge per prescription item for one year (2020-2021) (n = 591) or usual care (n = 469). Those in the intervention group did not pay the standard NZ$5 charge, and pharmacies billed the study for these. Participants continued to pay any other costs for prescription medicines. Those in the...

Does eliminating fees at point of access affect Irish general practice attendance rates in the under 6 years old population? A cross sectional study at six general practices

Irish medical journal, 2014

With the introduction of free point of access GP care for children aged under six imminent, we sought to determine consultation rates among this group. We interrogated data from practice management systems at six general practices (total patient population 27080). A total of 1931 children aged under six were responsible for 5814 surgery consultations. The mean annual consultation rate was 3.01; 4.91 for GMS' patients, 5.07 for 'Doctor Visit' patients and 2.03 for private patients. Our findings suggest the introduction of free GP care for children under six will considerably increase GP consultations. We also highlight the value of routinely collected general practice data in facilitating health services planning. We estimate that there will be an additional 750,000 GP consultations annually.

Co-payments for health care: what is their real cost?

Australian health review : a publication of the Australian Hospital Association, 2014

Based on the premise that current trends in healthcare spending are unsustainable, the Australian Government has proposed in the recent Budget the introduction of a compulsory $7 co-payment to visit a General Practitioner (GP), alongside increased medication copayments. This paper is based on a recent submission to the Senate Inquiry into the impact of out-of-pocket costs in Australia. It is based on a growing body of evidence highlighting the substantial economic burden faced by individuals and families as a result of out-of-pocket costs for health care and their flow-on effects on healthcare access, outcomes and long-term healthcare costs. It is argued that a compulsory minimum co-payment for GP consultations will exacerbate these burdens and significantly undermine the tenets of universal access in Medicare. Alternative recommendations are provided that may help harness unsustainable health spending while promoting an equitable and fair health system.