In 2010–2012, new outpatient service locations were established in Hungarian micro-regions,
which had lacked such capacities before. We exploit this quasi-experiment to estimate
the effect of geographical accessibility on outpatient case numbers using both individual-level
and semi-aggregate panel data. We find a 24–27 per cent increase of case numbers as
a result of the establishments. Our specialty-by-specialty estimates imply that a
1-min reduction of travel time to the nearest outpatient unit increases case numbers
for example by 0.9 per cent in internal care and 3.1 per cent in rheumatology. The
size of the new outpatient capacities has a separate effect, raising the possibility
of the presence of supplier-induced demand.
By combining a fixed-effects logit and a fixed-effects truncated Poisson estimator,
we decompose the effects into increases in the probability of ever visiting a doctor
on the one hand and an increase of the frequency of visits on the other hand. We find
that new visits were dominant in the vast majority of specialties, whereas both margins
were important for example in rheumatology. Finally, we demonstrate the usefulness
of the fixed-effects truncated Poisson estimator in modelling count data by examining
its robustness by simulations.
