Utilisation of physician services in the 50+ population: the relative importance of individual versus institutional factors in 10 European countries

  • Kristian BolinEmail author
  • Anna Lindgren
  • Björn Lindgren
  • Petter Lundborg


We analysed the relative importance of individual versus institutional factors in explaining variations in the utilisation of physician services among the 50+ in ten European countries. The importance of the latter was investigated, distinguishing between organisational (explicit) and cultural (implicit) institutional factors, by analysing the influence of supply side factors, such as physician density and physician reimbursement, and demand side factors, such as co-payment and gate-keeping, while controlling for a number of individual characteristics, using cross-national individual-level data from SHARE. Individual differences in health status accounted for about 50% of the between-country variation in physician visits, while the organisational and cultural factors considered each accounted for about 15% of the variation. The organisational variables showed the expected signs, with higher physician density being associated with more visits and higher co-payment, gate-keeping, and salary reimbursement being associated with less visits. When analysing specialist visits separately, however, organisational and cultural factors played a greater role, each accounting for about 30% of the between-country variation, whereas individual health differences only accounted for 11% of the variation.


Healthcare utilisation Physician visits Cross-country analysis SHARE Europe 

JEL Classifications

I11 I18 


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Copyright information

© Springer Science+Business Media, LLC 2008

Authors and Affiliations

  • Kristian Bolin
    • 1
    • 2
    • 3
    Email author
  • Anna Lindgren
    • 1
    • 4
    • 5
  • Björn Lindgren
    • 1
    • 4
    • 6
    • 7
  • Petter Lundborg
    • 1
    • 8
    • 9
    • 10
  1. 1.LUCHE (Lund University Centre for Health Economics)LundSweden
  2. 2.Vårdal instituteLund UniversityLundSweden
  3. 3.Department of EconomicsLund UniversityLundSweden
  4. 4.Department of Health SciencesLund UniversityLundSweden
  5. 5.Centre for Mathematical SciencesLund UniversityLundSweden
  6. 6.Institute for Economic ResearchLund UniversityLundSweden
  7. 7.National Bureau of Economic ResearchCambridgeUSA
  8. 8.Department of EconomicsFree UniversityAmsterdamThe Netherlands
  9. 9.Tinbergen InstituteAmsterdamThe Netherlands
  10. 10.IZABonnGermany

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