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The European Journal of Health Economics

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Open Access 01-11-2019 | Care | Original Research

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

Authors: Naimi Johansson, Niklas Jakobsson, Mikael Svensson

Published in: The European Journal of Health Economics | Issue 8/2019

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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Income is measured as the equivalized disposable income of the household, which is calculated taking into account all incomes of the household (family), weighted by the number of individuals in the household and their age. Disposable income includes wages, business profits, transfers, pensions, unemployment insurance payouts, taxes, profits from capital, etc. The sum can be negative. The 1st income quartile corresponds to the group with the lowest incomes.

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Title: Effects of primary care cost-sharing among young adults: varying impact across income groups and gender
Authors: Naimi Johansson
Niklas Jakobsson
Mikael Svensson
Publication date: 01-11-2019
Publisher: Springer Berlin Heidelberg
Keyword: Care
Published in: The European Journal of Health Economics / Issue 8/2019
Print ISSN: 1618-7598
Electronic ISSN: 1618-7601
DOI: https://doi.org/10.1007/s10198-019-01095-6

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