RESUMO
Assessing use of physician visits by people is fundamental as this is the main theme and starting point in medical services. The aim of this study was to evaluate fluctuations in public demand for GP and specialist's services [those who had contract with social security organization [SSO]] with regard to tariffs, access and rates of patient's cost-sharing. This study is descriptive and analytical. Analysis was performed throughout the country, based on time series data of institutes in contract with SSO. After data collection, GP and specialist services market were studied, both from the perspective of demand and supply, regarding both government and private tariffs. Then the role of the amount of patient out-of-pocket in service utilization was analyzed. During 1998-2008, patient out-of-pocket percentage has increased from 30 to 67% for SSO GP services while it has increased from 30 to 75% for SSO specialists. The average SSO GP visits per person has decreased from 1.13 in 1998 to 0.88 in 2008; meanwhile, the average SSO specialist visits per person has increased from 0.65 to 0.76. It seems that decreased average GP visit is due to increased patient out-of-pocket in institution under contract with SSO, which cause patients to seek these services from cheaper providers. However, specialist visits are more inelastic and there is no proper substitute for their services; thus, despite increased patient out-of-pocket, patients have to receive services from SSO specialists