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Women and low-income individuals are more affected by patient out-of-pocket prices

News: Aug 15, 2019

A new research study published in the European Journal of Health Economics shows that when 20-year-olds in Västra Götaland have to pay out-of-pocket, the number of primary care physician visits decrease by 7%. Additionally, the study shows that different groups are affected differently: the effect is large among women and among low-income individuals.

Patient out-of-pocket prices are a part of our health care system, but the rules and level differ across the Swedish regions. Given the large resources spent on health care, it is important to understand how the design of the system impact health care use, and in turn out health.

- The level of patient copayments can seem arbitrary, and we know quite little about the actual effects of patient out-of-pocket prices in Sweden, says Naimi Johansson, PhD student in health economics at Health Metrics.

Previous research, mainly from other countries, have shown that out-of-pocket prices modestly reduce health care use. But it has proven difficult to do direct comparison of how different groups, such as different income groups, are affected.

In the mentioned research study, Naimi Johansson together with Mikael Svensson, Health Metrics and Niklas Jakobsson, Karlstad University, examines how visits to primary care physician in Västra Götaland are affected with young adults transfer from free health care to from their 20th birthday need to pay copayments. The study is performed using register data from Region Västra Götaland and Statistics Sweden and include around 73,000 individuals between 18 and 22 years old.

The study shows that the number of physician visits in primary care are reduced by 7% when young adults have to pay a copayment of 100 kronor. Moreover, the results show that the effect differs across different groups. The impact is larger among women than among men, and larger among individuals of low-income families than among individuals of high-income families. Among low-income women, the effect is most prominent with a 14% reduction.

- It is interesting, that despite a relatively low price, we find a reduction in the number of physician visits. That we additionally can show that the effect differs across different groups is important for policy makers. But it is essential to point out that in our study, we cannot see what type of visits are avoided due to the copayment, if it is for example less necessary visits that decrease. This is a relevant question for the future research, says Naimi Johansson.

Link to the research article in the European Journal of Health Economics. For more information about the study, contact Naimi Johansson.


Page Manager: Naimi Johansson|Last update: 12/21/2015

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