Int. J. Environ. Res. Public Health 2010, 7(6), 2708-2725; doi:10.3390/ijerph7062708
Review

Empirical Models of Demand for Out-Patient Physician Services and Their Relevance to the Assessment of Patient Payment Policies: A Critical Review of the Literature

1 Department of Health Organization, Policy and Economics, CAPHRI, Medical Center, Faculty of Health, Medicine and Life Sciences, Maastricht University, P.O. Box 616, 6200 MD Maastricht, The Netherlands 2 Research Center for Education and the Labour Market (ROA), School of Business and Economics, Maastricht University, P.O. Box 616, 6200 MD Maastricht, The Netherlands 3 Topinstitute Evidence Based Education Research (TIER), Maastricht University, P.O. Box 616, 6200 MD Maastricht, The Netherlands
* Author to whom correspondence should be addressed.
Received: 21 May 2010; in revised form: 10 June 2010 / Accepted: 21 June 2010 / Published: 23 June 2010
(This article belongs to the Special Issue Health Economics)
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Abstract: This paper reviews the existing empirical micro-level models of demand for out-patient physician services where the size of patient payment is included either directly as an independent variable (when a flat-rate co-payment fee) or indirectly as a level of deductibles and/or co-insurance defined by the insurance coverage. The paper also discusses the relevance of these models for the assessment of patient payment policies. For this purpose, a systematic literature review is carried out. In total, 46 relevant publications were identified. These publications are classified into categories based on their general approach to demand modeling, specifications of data collection, data analysis, and main empirical findings. The analysis indicates a rising research interest in the empirical micro-level models of demand for out-patient physician services that incorporate the size of patient payment. Overall, the size of patient payments, consumer socio-economic and demographic features, and quality of services provided emerge as important determinants of demand for out-patient physician services. However, there is a great variety in the modeling approaches and inconsistencies in the findings regarding the impact of price on demand for out-patient physician services. Hitherto, the empirical research fails to offer policy-makers a clear strategy on how to develop a country-specific model of demand for out-patient physician services suitable for the assessment of patient payment policies in their countries. In particular, theoretically important factors, such as provider behavior, consumer attitudes, experience and culture, and informal patient payments, are not considered. Although we recognize that it is difficult to measure these factors and to incorporate them in the demand models, it is apparent that there is a gap in research for the construction of effective patient payment schemes.
Keywords: demand modeling; out-patient physician services; patient payments; policy analysis

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MDPI and ACS Style

Skriabikova, O.; Pavlova, M.; Groot, W. Empirical Models of Demand for Out-Patient Physician Services and Their Relevance to the Assessment of Patient Payment Policies: A Critical Review of the Literature. Int. J. Environ. Res. Public Health 2010, 7, 2708-2725.

AMA Style

Skriabikova O, Pavlova M, Groot W. Empirical Models of Demand for Out-Patient Physician Services and Their Relevance to the Assessment of Patient Payment Policies: A Critical Review of the Literature. International Journal of Environmental Research and Public Health. 2010; 7(6):2708-2725.

Chicago/Turabian Style

Skriabikova, Olga; Pavlova, Milena; Groot, Wim. 2010. "Empirical Models of Demand for Out-Patient Physician Services and Their Relevance to the Assessment of Patient Payment Policies: A Critical Review of the Literature." Int. J. Environ. Res. Public Health 7, no. 6: 2708-2725.

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