Non-Monetary Factors in the Demand for Medical Services: Some Empirical Evidence.
A discussion of the effects of travel time (as measured by distance) in determining demand for medical care as money-cost-to-patient falls because of increasing insurance coverage or availability of subsidized care. A model of demand for medical services is developed that includes a payment in money and time for private care. Predictions are then tested on a cross-sectional survey of about 2600 users of outpatient departments in New York City. The study supports the prediction that travel time functions as a price in determining demand for free medical services, and that free-care demand is more sensitive to time-price changes than nonfree-care demand. Two important policy implications emerge: (1) Improving transportation, locating clinics closer, or establishing satellite clinics around central facilities are viable means of increasing access to care. (2) If it is desirable to increase health consumption of target groups, income subsidies may be as effective as direct provision of services in achieving the goal. (For the [Journal of Political Economy].) 31 pp. Bibliog.