{"doi":"10.1093/eurpub/cku162.093","title":"How does a change in reimbursement system affect vertical and horizontal equity in healthcare utilization? Differences in GP visits before and after a change in reimbursement system in Stockholm County Council.","abstract":null,"journal":"European Journal of Public Health","year":2014,"id":623810,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":0,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":null,"is_data_producer":false,"deposit_databanks":null,"is_oa":false,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":null,"fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":1612352,"name":"D Bruce","orcid":null,"position":1,"is_corresponding":false},{"id":1612353,"name":"A Ponce de Leon","orcid":null,"position":2,"is_corresponding":false},{"id":1612354,"name":"B Burström","orcid":null,"position":3,"is_corresponding":false},{"id":1612351,"name":"J Agerholm","orcid":null,"position":0,"is_corresponding":false}],"reference_count":0,"raw_metadata":{"has_enrichment":true,"resolved":true,"title":"How does a change in reimbursement system affect vertical and horizontal equity in healthcare utilization? Differences in GP visits before and after a change in reimbursement system in Stockholm County Council.","abstract":"Background In 2008 a new health care reform was introduced in Stockholm County Council. The reimbursement system (RS) in primary care was changed from a need-weighted capitation (75%) with age and area specific socio-economic indicators used as proxies for need; to a system based more on fee-for-service (60%), less on only age weighted capitation (40%). This RS creates incentives for producing many visits and there is a risk that resources could divert from individuals with lower socioeconomic position as they often have more complex health issues and therefore demand more time and effort for each visit. This study investigates differences in horizontal- and vertical equity in visits to general practitioners (GP) before and after a change in RS by looking at both income differentials adjusted for need and differences between groups with different needs of healthcare. Methods Cross-sectional data from the public health survey in Stockholm County 2006 (n = 34,707) and 2010 (n = 30,767) were linked to register data on socio-demographic characteristics and healthcare utilization in 2007 and 2011. Information on self-reported health status was used to control for need of healthcare in different income groups and information on disease status where used to identify groups in higher need of healthcare. Negative binomial regression was used to analyze the differences in the income differentials in GP visits between the two years. Results Preliminary results suggest an increase in total number of visits to GPs from 2007 to 2011 of approximately 42%, with a pro poor income gradient for visits to GPs when controlling for need, both before and after the reform. Only one comparison (income group 4 (high) vs 1(low) in 2011 vs 2007) for women came out statistically significant indicating that women in income group 4 had relatively more visits to GP in 2011 in relation to women from income group 1. For all other comparison between income-groups there were no significant differences between 2007 and 2011. Conclusions Preliminary results suggest that the change in RS did not systematically affect horizontal equity in health care consumption when looking at total number of visits to GPs. Further analysis will investigate the vertical equity for vulnerable groups with higher needs. Key messages In this study we investigate how a change in reimbursement system for primary care affects horizontal and vertical equity in healthcare utilization. The preliminary results suggest that the change in RS did not systematically affect horizontal equity; further analysis will investigate if vertical equity is affected, looking at vulnerable groups.","is_dataset_classified":null,"base_score":0.0,"endowment":0.0,"datacite_reuse_total":0,"file_count":0,"downloads":0,"views":0,"has_version_chain":false,"is_dataset":false,"is_oa":false,"pmid":"19767382","pmcid":null,"openalex_id":"https://openalex.org/W2284838601","authors":[],"funders":[],"total_grants":0,"fwci":0.0,"citation_percentile":0.21029149,"influential_citations":0,"citation_trend":[],"oa_status":"bronze","license":null,"oa_locations":[{"url":"https://academic.oup.com/eurpub/article-pdf/24/suppl_2/cku162-093/9124236/cku162.093.pdf","host_type":"journal"},{"url":"https://academic.oup.com/eurpub/article-pdf/24/suppl_2/cku162-093/9124236/cku162.093.pdf","host_type":"publisher"},{"url":"https://doi.org/10.1093/eurpub/cku162.093","host_type":"journal"}],"fields_of_study":["Healthcare Policy and Management"],"mesh_terms":[],"keywords":["Capitation","Reimbursement","Equity (law)","Incentive","Health care","Socioeconomic status","Business","Medicine","Environmental health","Payment","Finance","Economic growth","Economics","Political science"],"sdg_mappings":[],"linked_datasets":[],"clinical_trials":[],"software_tools":[],"database_accessions":[],"source":"live","citation_network_status":"fetched"},"created_at":"2026-08-04T01:28:21.086301Z","pmid":null,"pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}