Abstract
Prevention has been identified as an effective strategy to lead healthy, active and independent lives in old age. Developing effective prevention programs requires understanding the influence of both individual and health system level factors on utilisation of specific services. This study examines the variations in utilisation of preventive services by the population aged 50 and over in 14 European countries, pooling data from the two waves of Survey of Health Ageing and Retirement in Europe and the British Household Panel Survey. The models used allow for the impact of individual level demand-side characteristics and supply-side health systems features to be separately identified. The analysis shows significant variations in preventive care utilisation both within and across European countries. In all countries, controlling for individual health status and country-level systemic differences, higher educated and higher income groups use more preventive services. At the health system level, high public health expenditures and high GP density is associated with a high level of preventive care use, but specialist density does not appear to have any effect. Moreover, payment schemes for GPs and specialists appear to significantly affect the incentives to provide preventive health care. In systems where doctors are paid by fee-for-service the utilisation of all health services, including cancer screening, are higher.
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Acknowledgments
This article uses data from SHARE release 2.3.0, as of November 13th 2009. SHARE data collection in 2004-2007 was primarily funded by the European Commission through its 5th and 6th framework programmes (project numbers QLK6-CT-2001- 00360; RII-CT-2006-062193; CIT5-CT-2005-028857). Additional funding by the US National Institute on Aging (grant numbers U01 AG09740-13S2; P01 AG005842; P01 AG08291; P30 AG12815; Y1-AG-4553-01; OGHA 04-064; R21 AG025169) as well as by various national sources is gratefully acknowledged (see http://www.share-project.org for a full list of funding institutions). This article also uses data from the BHPS study which is funded by the Economic and Social Research Council (ESRC). The data was originally collected by the ESRC Research Centre on Micro-Social Change at the University of Essex. Over time, additional funding for the British Household Panel Survey (BHPS) has been provided by the Health Education Authority (HEA), Office for National Statistics (ONS) and Eurostat. The Northern Ireland sample, included from Wave 11, is jointly funded by the Economic and Social Research Council (ESRC) and various Northern Ireland government departments. Our research benefited from the jointed financial support of the French Institute for Health Promotion and Health Education (INPES), the National Authority for Health (HAS), the National Institute for Health and Medical Research (INSERM), the National Health Insurance Fund for Self-employed (RSI) as part of the research program “Prevention” supported by the French Institute for Public Health Research (IRESP) in 2007.
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Jusot, F., Or, Z. & Sirven, N. Variations in preventive care utilisation in Europe. Eur J Ageing 9, 15–25 (2012). https://doi.org/10.1007/s10433-011-0201-9
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DOI: https://doi.org/10.1007/s10433-011-0201-9