Utilisation of specialist care in the Netherlands before and after 2006

The investigation in this thesis concluded that education has a significant positive effect on the probability of visiting a specialist in 2004. For 2007 and for the amount of specialist care once someone has visited a specialist no significant effects were found. For someone´s type of insurance in 2004 just a positive significant effect on the amount of specialist care used has been found in 2007. For 2004 no significant effects of type of insurance in 2004 on the probability of care nor significant effects on the amount of care once someone visited a specialist already once, are shown. The results on education mentioned above are in contradiction with the results of Naaktgeboren (2012). This research has shown that the inequity according to education has increased after the health insurance reform of 2006. The finding of an increase in specialist care utilisation after the reform for people who were privately insured before 2006 was also obtained in this same research and is in line with the findings of this investigation. Both effects were the motive to investigate in the effect of education and insurance on specialist care utilisation to conclude if the goals of cost containment and equal access were met in the new health insurance system. To model specialist care utilisation predisposing, enabling and need factors are taken into account. Data are obtained from the Survey of Health, Ageing and Retirement in Europe (SHARE project) for the year 2004 (before the system) and 2007 (after the system). A two part Hurdle model is used to estimate both the effects of education and insurance on the probability of visiting a specialist in the previous twelve months and to estimate the effects of education and insurance on the amount of specialist care used once someone has visited a specialist. This investigation does not confirm the increasing inequity on specialist care utilisation according to education after the health insurance reform which is in line with the objective of equal access of the new health insurance system. The fact that specialist care utilisation has increased after the reform is a negative conclusion for the objectives of the new health insurance system. This conclusion goes against the objective of cost containment.