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Effects of primary care cost-sharing among young adults: varying impact across income groups and gender.

Journal article
Authors Naimi Johansson
Niklas Jakobsson
Mikael Svensson
Published in European Journal of Health Economics
Volume 20
Issue 8
Pages 1271-1280
ISSN 1618-7598
Publication year 2019
Published at Institute of Medicine, Department of Public Health and Community Medicine, Health Metrics
Pages 1271-1280
Language en
Links link.springer.com/article/10.1007/s...
https://doi.org/10.1007/s10198-019-...
Subject categories Health Care Service and Management, Health Policy and Services and Health Economy, Economics

Abstract

We estimate the price sensitivity in health care among adolescents and young adults, and assess how it varies across income groups and gender, using a regression discontinuity design. We use the age differential cost-sharing in Swedish primary care as our identification strategy. At the 20th birthday, the copayment increases from €0 to approx. €10 per primary care physician visit and close to this threshold the copayment faced by each person is distributed almost as good as if randomized. The analysis is performed using high-quality health care and economic register data of 73,000 individuals aged 18-22. Our results show that the copayment decreases the average number of visits by 7%. Among women visits are reduced by 9%, for low-income individuals by 11%, and for low-income women by 14%. In conclusion, modest copayments have significant utilization effects, and even in a policy context with relatively low income inequalities, the effect is substantially larger in low-income groups and among women.

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