title: Public Healthcare Entitlements and Healthcare Utilisation among the Older Population in Ireland.
abstract: The use of direct out-of-pocket payments to finance general practitioner (GP) care by the majority of the population in Ireland is unusual in a European context. Currently, approximately 40% of the population have means-tested access to free GP care, while the remainder must pay the full out-of-pocket cost. In this paper, we use data from The Irish Longitudinal Study on Ageing (TILDA) to examine the impact of the current system of public healthcare entitlements on GP utilisation among the older population. Using difference-in-difference propensity score matching methods, we find significant effects of changes in public healthcare entitlements on GP utilisation (i.e. introducing user fees reduces utilisation, while removing them increases utilisation). There is limited evidence of offset effects on other types of healthcare utilisation. The results have direct implications for current Irish health policy, and add to the international literature on the effects of insurance on healthcare utilisation. Copyright © 2016 John Wiley & Sons, Ltd.
authors.affiliation: Wenlan School of Business, Zhongnan University of Economics and Law, Wuhan, China.|The Irish Longitudinal Study on Ageing (TILDA), Trinity College, Dublin, Ireland.|Institute for the Study of Labor (IZA), Bonn, Germany.
authors.forename: Yuanyuan
authors.initials: Y
authors.lastname: Ma
authors.affiliation: The Irish Longitudinal Study on Ageing (TILDA), Trinity College, Dublin, Ireland.|Economic and Social Research Institute, Dublin, Ireland.
authors.forename: Anne
authors.initials: A
authors.lastname: Nolan
mesh_terms: D058005:General Practitioners; D005102:Health Expenditures / Q000706:statistics & numerical data*; D006297:Health Services Accessibility / Q000191:economics; D006801:Humans; D019458:Insurance Coverage / Q000191:economics*; D007494:Ireland; D008137:Longitudinal Studies; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*
keywords: The Irish Longitudinal Study on Ageing (TILDA); healthcare utilisation; older population; public healthcare entitlements; user fees