Regional variation in health care utilization in Sweden - The importance of demand-side factors
dc.contributor.author | Johansson, Naimi | |
dc.contributor.author | Jakobsson, Lars Niklas | |
dc.contributor.author | Svensson, Mikael | |
dc.date.accessioned | 2019-04-03T10:57:29Z | |
dc.date.accessioned | 2019-04-08T12:34:44Z | |
dc.date.available | 2019-04-03T10:57:29Z | |
dc.date.available | 2019-04-08T12:34:44Z | |
dc.date.issued | 2018-06-04 | |
dc.identifier.citation | Johansson, Jakobsson N, Svensson M. Regional variation in health care utilization in Sweden - The importance of demand-side factors. BMC Health Services Research. 2018;18(403) | en |
dc.identifier.issn | 1472-6963 | |
dc.identifier.issn | 1472-6963 | |
dc.identifier.uri | https://hdl.handle.net/10642/6935 | |
dc.description.abstract | Background: Differences in health care utilization across geographical areas are well documented within several countries. If the variation across areas cannot be explained by differences in medical need, it can be a sign of inefficiency or misallocation of public health care resources. Methods: In this observational, longitudinal panel study we use regional level data covering the 21 Swedish regions (county councils) over 13 years and a random effects model to assess to what degree regional variation in outpatient physician visits is explained by observed demand factors such as health, demography and socioeconomic factors. Results: The results show that regional mortality, as a proxy for population health, and demography do not explain regional variation in visits to primary care physicians, but explain about 50% of regional variation in visits to outpatient specialists. Adjusting for socio-economic and basic supply-side factors explains 33% of the regional variation in primary physician visits, but adds nothing to explaining the variation in specialist visits. Conclusion: 50–67% of regional variation remains unexplained by a large number of observable regional characteristics, indicating that omitted and possibly unobserved factors contribute substantially to the regional variation. We conclude that variations in health care utilization across regions is not very well explained by underlying medical need and demand, measured by mortality, demographic and socio-economic factors. | en |
dc.language.iso | en | en |
dc.publisher | BMC | en |
dc.relation.ispartofseries | BMC Health Services Research;18:403 | |
dc.rights | © The Author(s). 2018 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. | en |
dc.rights.uri | http://creativecommons.org/licenses/by/4.0/ | |
dc.subject | Regional variations | en |
dc.subject | Health care utilizations | en |
dc.subject | Demands | en |
dc.subject | Panel data | en |
dc.subject | Random effects | en |
dc.title | Regional variation in health care utilization in Sweden - The importance of demand-side factors | en |
dc.type | Journal article | en |
dc.type | Peer reviewed | en |
dc.date.updated | 2019-04-03T10:57:29Z | |
dc.description.version | publishedVersion | en |
dc.identifier.doi | https://dx.doi.org/10.1186/s12913-018-3210-y | |
dc.identifier.cristin | 1597966 | |
dc.source.journal | BMC Health Services Research |
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Med mindre annet er angitt, så er denne innførselen lisensiert som © The Author(s). 2018 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.