User charges and their impact on planned and unplanned hospital use: evidence from Portugal

Abstract

Predicted values for individual’s expected costs related to emergency department visits and primary care unit (PCU) appointments are constructed using Portuguese survey data. These are used in regressions of count data and binary dependent variable models to identify the partial effect of user charges on (1)yearly emergency department visits and(2)the probability that an individual has an appointment at a PCU in a year. User charges are found to reduce both types of use. Individuals with chronic conditions are less impacted. No evidence is found to suggest that individual’s income levels influence their sensitivity to user charges.