Preventive care: underused even when free. Is there something else at work?

Explaining the rationale of preventive care underuse is a difficult task considering its great benefits for health. Underuse is even more difficult to explain in countries like Italy where preventive care can be obtained for free. In this article we investigate the determinants of prevention underuse with an empirical model based on human capital theory which also includes three factors to which little attention has been paid so far: role played by the General Practitioner (GP), nonmonetary barriers to access and health beliefs. We apply a recursive probit model explaining both recourse to prevention and to the GP which allows us to adequately measure the effect of the latter on the former and to quantitatively compare the determinants of curative and preventive care. We find that the GP plays a minor role in prevention use but that nonmonetary barriers to access and health beliefs are strong determinants of preventive care demand. Finally, we also find support for both Grossman's capital depreciation theory (at younger ages) and Cropper's shorter pay-off period theory (at older ages).