Public healthcare eligibility and the utilisation of GP services by older people in Ireland

As the first point of contact for most individuals' interactions with the health service, the role of the general practitioner (GP) is crucial. The current Irish system of financing GP care is unusual internationally, with the requirement for a large proportion of the population to pay the full cost of GP care a particular concern. Previous research on the impact of the Irish system of public healthcare eligibility on utilisation has largely concentrated on the total adult population and there has been little research on the older population. This is despite the fact that the older population are heavy users of healthcare and that different factors may be more important in determining healthcare utilisation among the older population. Using nationally representative data on a large sample of individuals aged 50+ from the Irish Longitudinal Study on Ageing (TILDA), this paper examines the determinants of GP utilisation, with a particular focus on the impact of the Irish system of public healthcare eligibility. One of the main advantages of TILDA over existing national and international datasets is the availability of objective information on the health of respondents, collected via nurse-led health assessments. The results indicate that eligibility for free public healthcare is associated with a significantly higher number of GP visits, even after controlling for a wide variety of both subjective and objective indicators of health need. However, we find no evidence for a significant income gradient in GP visiting among the older Irish population without full eligibility for free GP care. (C) 2014 Elsevier B.V. All rights reserved.