Department of Economics, Cork University Business School, University College Cork, Ireland.
Health Policy. 2022 Jul;126(7):652-660. doi: 10.1016/j.healthpol.2022.04.005. Epub 2022 Apr 14.
Health systems' characteristics influence individuals' health care utilisation. Unlike their European neighbours the majority of Irish citizens pay for General Practitioner (GP) care. The current strategy for health care reform proposes universal GP care (i.e. the removal of GP care fees), to be introduced on a phased basis, prioritising under 18s.
Employing data from the Growing Up in Ireland survey, and controlling for health care need, and other predisposing and enabling factors, propensity score matching is used to estimate the effect of GP cover (free GP care at point of use) on GP utilisation over a 12-month period amongst 16/17 year olds (n= 4308).
Results indicate having GP cover increases the average number of GP consultations by 38% per annum. When the sample is restricted to individuals without chronic conditions, a 42% increase in annual number of GP consultations is found. It is reasonable to expect that extending free GP care via a universal care model would be associated with a higher propensity to utilise GP services amongst 16/17 year olds.
This has economic implications for health care budgets and workforce planning. While most adolescents are healthy, investment in their health provides current and future health benefits; however a universal system will require investment, necessitating displacement of resources elsewhere, to meet demand.
卫生系统的特点影响个人的医疗保健利用。与欧洲邻国不同，大多数爱尔兰公民需要支付全科医生（GP）的医疗费用。目前的医疗保健改革策略建议实行全民 GP 医疗保健（即取消 GP 医疗费用），并分阶段实施，优先考虑 18 岁以下人群。
本研究利用爱尔兰成长调查的数据，在控制医疗保健需求以及其他倾向因素和促成因素的情况下，采用倾向评分匹配法估计在 12 个月内，GP 覆盖（在使用点免费 GP 护理）对 16/17 岁青少年（n=4308）的 GP 利用的影响。
结果表明，拥有 GP 覆盖可使 GP 咨询的平均次数每年增加 38%。当样本仅限于没有慢性疾病的个体时，发现每年 GP 咨询次数增加了 42%。可以合理地预期，通过全民保健模式提供免费 GP 护理将与 16/17 岁青少年更倾向使用 GP 服务相关。
这对医疗保健预算和劳动力规划具有经济影响。虽然大多数青少年身体健康，但对他们的健康投资可以提供当前和未来的健康益处；然而，全民保健系统需要投资，需要从其他地方转移资源来满足需求。
