Self-rated health and primary care utilization: is selection into healthcare endogenously determined ?

Abstract EN

This study assesses the causal effects of primary care utilization on subjective health status in Turkey using individual-level data from the 2012 Health Research Survey.

Employing recursive bivariate models that take into account the possibility that selection into healthcare might be correlated with the subjective health status of the respondent, we find that selection into primary care is endogenously determined and that the utilization of preventive care significantly improves one’s self-rated health after controlling for sociodemographics, socioeconomic status, health behavior and risk factors and access to healthcare.

The distribution of treatment effects suggests significant between- and within-inequalities in health gains from preventive care utilization in disfavor of chronic patients.

Analysis also points out that barriers to healthcare access are associated with lower self-rated health and that significant location-based inequalities exist in the utilization of preventive care among chronic patients.

GP care utilization however, only exerts a trivial causal effect on self-rated health exclusively among females, rural residents and chronic patients.