Abstract：
Voluntary private health insurance (VPHI) has gained popularity in universal public healthcare systems. We studied how the local provision of healthcare services correlated with VPHI take-up in Finland. Nationwide register data from a Finnish insurance company was aggregated to the local level and augmented with high-quality data on public and private primary care providers\' geographical closeness and fees. We found that the sociodemographic characteristics explained the VPHI take-up more than public or private healthcare provision. The VPHI take-up was negatively associated with distance to the nearest private clinic, while the associations with distance to public health stations were statistically weak. Fees and co-payments for healthcare services were not associated with insurance take-up, meaning that the geographical closeness of providers explained the take-up more than the price of services. On the other hand, we found that VPHI take-up was higher when local employment, income and education levels were higher.
摘要：
自愿私人健康保险（VPHI）在全民公共医疗系统中越来越受欢迎。我们研究了芬兰当地提供的医疗服务与VPHI接受的关系。来自芬兰一家保险公司的全国注册数据被汇总到地方一级，并增加了关于公共和私人初级保健提供者的地理距离和费用的高质量数据。我们发现，社会人口统计学特征比公共或私人医疗保健提供更能解释VPHI的接受。VPHI的服用与到最近的私人诊所的距离呈负相关，而与公共卫生站距离的关联在统计上较弱。医疗服务的费用和共同支付与保险接受无关，这意味着提供商的地理距离比服务价格更能解释使用量。另一方面,我们发现当本地就业时，VPHI的使用率更高，收入和教育水平更高。
