IDEAS home Printed from https://ideas.repec.org/a/taf/applec/v36y2004i20p2237-2251.html
   My bibliography  Save this article

Modelling demand and supply influences on utilization: A flow demand model to predict hospital utilization at the small area level

Author

Listed:
  • Monica Oliveira

Abstract

This study outlines a model to predict hospital utilization at the small area level within a National Health Service (NHS) institutional context. The proposed approach departs from alternative analyses based on utilization flows of hospital care between a local population and a hospital. A flow demand model is outlined that relates flow demand to utilization flows; models the interaction between hospital supply and utilization of alternative hospitals; captures the process of demand for hospital care, with special attention given to the role of other health care sectors, to the organizational and institutional context of the hospital system and to geographic variations. The flow approach partly overcomes the problem of dealing with simultaneity of determination between supply and demand. A two-part econometric model suitable to estimate the flow demand model for prediction purposes is tested and applied to the Portuguese health care system. The results show the model to be robust and to provide key information for defining future hospital policies at the central level.

Suggested Citation

  • Monica Oliveira, 2004. "Modelling demand and supply influences on utilization: A flow demand model to predict hospital utilization at the small area level," Applied Economics, Taylor & Francis Journals, vol. 36(20), pages 2237-2251.
  • Handle: RePEc:taf:applec:v:36:y:2004:i:20:p:2237-2251
    DOI: 10.1080/0003684042000280553
    as

    Download full text from publisher

    File URL: http://www.tandfonline.com/doi/abs/10.1080/0003684042000280553
    Download Restriction: Access to full text is restricted to subscribers.

    File URL: https://libkey.io/10.1080/0003684042000280553?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    As the access to this document is restricted, you may want to search for a different version of it.

    References listed on IDEAS

    as
    1. Manning, Willard G., 1998. "The logged dependent variable, heteroscedasticity, and the retransformation problem," Journal of Health Economics, Elsevier, vol. 17(3), pages 283-295, June.
    2. John Hodgson, M. & Rosing, K. E. & Leontien, A. & Storrier, G., 1996. "Applying the flow-capturing location-allocation model to an authentic network: Edmonton, Canada," European Journal of Operational Research, Elsevier, vol. 90(3), pages 427-443, May.
    3. L D Mayhew & R W Gibberd & H Hall, 1986. "Predicting Patient Flows and Hospital Case-Mix," Environment and Planning A, , vol. 18(5), pages 619-638, May.
    4. Leung, Siu Fai & Yu, Shihti, 1996. "On the choice between sample selection and two-part models," Journal of Econometrics, Elsevier, vol. 72(1-2), pages 197-229.
    5. Evans, R.G. & Stoddart, G.L., 1990. "Producing Health, Consuming Health Care," Centre for Health Services and Policy Research 90:13r, University of British Columbia - Centre for Health Services and Policy Research..
    6. Duan, Naihua, et al, 1983. "A Comparison of Alternative Models for the Demand for Medical Care," Journal of Business & Economic Statistics, American Statistical Association, vol. 1(2), pages 115-126, April.
    7. Roy Carr-Hill & Geoffrey Hardman & Stephen Martin & Stuart Peacock & Trevor Sheldon & Peter Smith, 1994. "A formula for distributing NHS revenues based on small area use of hospital beds," Working Papers 022cheop, Centre for Health Economics, University of York.
    8. Hallefjord, Åsa & Jörnsten, Kurt, 1986. "Gravity models with multiple objectives-- Theory and applications," Transportation Research Part B: Methodological, Elsevier, vol. 20(1), pages 19-39, February.
    9. Oliveira, Monica Duarte & Bevan, Gwyn, 2003. "Measuring geographic inequities in the Portuguese health care system: an estimation of hospital care needs," Health Policy, Elsevier, vol. 66(3), pages 277-293, December.
    10. Evans, Robert G. & Stoddart, Gregory L., 1990. "Producing health, consuming health care," Social Science & Medicine, Elsevier, vol. 31(12), pages 1347-1363, January.
    11. R Evans & G Stoddart, 1990. "Producing Health, Consuming Health Care," Centre for Health Economics and Policy Analysis Working Paper Series 1990-06, Centre for Health Economics and Policy Analysis (CHEPA), McMaster University, Hamilton, Canada.
    12. Hugh Gravelle & Matthew Sutton & Stephen Morris & Frank Windmeijer & Alastair Leyland & Chris Dibben & Mike Muirhead, 2003. "Modelling supply and demand influences on the use of health care: implications for deriving a needs‐based capitation formula," Health Economics, John Wiley & Sons, Ltd., vol. 12(12), pages 985-1004, December.
    13. Manning, Willard G. & Mullahy, John, 2001. "Estimating log models: to transform or not to transform?," Journal of Health Economics, Elsevier, vol. 20(4), pages 461-494, July.
    14. Nigel Rice & Peter Smith, 1999. "Approaches to capitation and risk adjustment in health care: an international survey," Working Papers 038cheop, Centre for Health Economics, University of York.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Simon Jones & Jessica Wardlaw & Susan Crouch & Michelle Carolan, 2011. "Modelling catchment areas for secondary care providers: a case study," Health Care Management Science, Springer, vol. 14(3), pages 253-261, September.
    2. Johnathan Munn & Caroliniana Padgett, 2015. "The effects of agglomeration on interregional hospital patient flow," Journal of Economics and Finance, Springer;Academy of Economics and Finance, vol. 39(2), pages 412-430, April.
    3. Nan Jiang & Gail Pacheco, 2014. "Demand in New Zealand hospitals: expect the unexpected?," Applied Economics, Taylor & Francis Journals, vol. 46(36), pages 4475-4489, December.
    4. Gerald Manthalu, 2019. "User fee exemption and maternal health care utilisation at mission health facilities in Malawi: An application of disequilibrium theory of demand and supply," Health Economics, John Wiley & Sons, Ltd., vol. 28(4), pages 461-474, April.
    5. Tetsuji Yamada & Chia-Ching Chen & Chiyoe Murata & Hiroshi Hirai & Toshiyuki Ojima & Katsunori Kondo & Joseph R. Harris III, 2015. "Access Disparity and Health Inequality of the Elderly: Unmet Needs and Delayed Healthcare," IJERPH, MDPI, vol. 12(2), pages 1-28, February.

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Fabio Pammolli & Francesco Porcelli & Francesco Vidoli & Monica Auteri & Guido Borà, 2017. "La spesa sanitaria delle Regioni in Italia - Saniregio2017," Working Papers CERM 01-2017, Competitività, Regole, Mercati (CERM).
    2. Borislava Mihaylova & Andrew Briggs & Anthony O'Hagan & Simon G. Thompson, 2011. "Review of statistical methods for analysing healthcare resources and costs," Health Economics, John Wiley & Sons, Ltd., vol. 20(8), pages 897-916, August.
    3. Vidoli, Francesco & Auteri, Monica, 2022. "Health-care demand and supply at municipal level: A spatial disaggregation approach," Socio-Economic Planning Sciences, Elsevier, vol. 84(C).
    4. Buntin, Melinda Beeuwkes & Zaslavsky, Alan M., 2004. "Too much ado about two-part models and transformation?: Comparing methods of modeling Medicare expenditures," Journal of Health Economics, Elsevier, vol. 23(3), pages 525-542, May.
    5. Melanie Levy, 2022. "The rise of the Swiss regulatory healthcare state: On preserving the just in the quest for the better (or less expensive?)," Regulation & Governance, John Wiley & Sons, vol. 16(2), pages 427-447, April.
    6. Jones, A.M, 2010. "Models For Health Care," Health, Econometrics and Data Group (HEDG) Working Papers 10/01, HEDG, c/o Department of Economics, University of York.
    7. Bryant, Toba & Raphael, Dennis & Schrecker, Ted & Labonte, Ronald, 2011. "Canada: A land of missed opportunity for addressing the social determinants of health," Health Policy, Elsevier, vol. 101(1), pages 44-58, June.
    8. Coast, Joanna, 2018. "A history that goes hand in hand: Reflections on the development of health economics and the role played by Social Science & Medicine, 1967–2017," Social Science & Medicine, Elsevier, vol. 196(C), pages 227-232.
    9. Toni Mora & Joan Gil & Antoni Sicras-Mainar, 2012. "The Influence of BMI, Obesity and Overweight on Medical Costs: A Panel Data Approach," Working Papers 2012-08, FEDEA.
    10. Liu, Lei & Strawderman, Robert L. & Cowen, Mark E. & Shih, Ya-Chen T., 2010. "A flexible two-part random effects model for correlated medical costs," Journal of Health Economics, Elsevier, vol. 29(1), pages 110-123, January.
    11. Jacklin, Kristen, 2009. "Diversity within: Deconstructing Aboriginal community health in Wikwemikong Unceded Indian Reserve," Social Science & Medicine, Elsevier, vol. 68(5), pages 980-989, March.
    12. Toni Mora & Joan Gil & Antoni Sicras-Mainar, 2015. "The influence of obesity and overweight on medical costs: a panel data perspective," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 16(2), pages 161-173, March.
    13. Jay Dev Dubey, 2021. "Measuring Income Elasticity of Healthcare-Seeking Behavior in India: A Conditional Quantile Regression Approach," Journal of Quantitative Economics, Springer;The Indian Econometric Society (TIES), vol. 19(4), pages 767-793, December.
    14. Shahin Shooshtari & Carol Harvey & Evelyn Ferguson & Tuula Heinonen & Syeed Khan, 2014. "Effects of Remittance Behavior on the Lives of Recent Immigrants to Canada from the Philippines: A Population-Based Longitudinal Study," Journal of Family and Economic Issues, Springer, vol. 35(1), pages 95-105, March.
    15. C. GEAY & M. KOUBI & G. de LAGASNERIE, 2015. "Evolution of outpatient healthcare expenditure, a dynamic micro-simulation using the Destinie model," Documents de Travail de l'Insee - INSEE Working Papers g2015-15, Institut National de la Statistique et des Etudes Economiques.
    16. Chia-Mei Shih & Yu-Hua Wang & Li-Fan Liu & Jung-Hua Wu, 2020. "Profile of Long-Term Care Recipients Receiving Home and Community-Based Services and the Factors That Influence Utilization in Taiwan," IJERPH, MDPI, vol. 17(8), pages 1-15, April.
    17. Christine Le Clainche & Sandy Tubeuf, 2016. "Nudging, intervening or rewarding," Politics, Philosophy & Economics, , vol. 15(2), pages 170-189, May.
    18. Huguet, Nathalie & Kaplan, Mark S. & Feeny, David, 2008. "Socioeconomic status and health-related quality of life among elderly people: Results from the Joint Canada/United States Survey of Health," Social Science & Medicine, Elsevier, vol. 66(4), pages 803-810, February.
    19. Daniela Adam & Theresa Keller & Axel Mühlbacher & Maximilian Hinse & Katja Icke & Michael Teut & Benno Brinkhaus & Thomas Reinhold, 2019. "The Value of Treatment Processes in Germany: A Discrete Choice Experiment on Patient Preferences in Complementary and Conventional Medicine," The Patient: Patient-Centered Outcomes Research, Springer;International Academy of Health Preference Research, vol. 12(3), pages 349-360, June.
    20. Galina Besstremyannaya, 2012. "Estimating income equity in social health insurance system," Working Papers w0172, New Economic School (NES).

    More about this item

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:taf:applec:v:36:y:2004:i:20:p:2237-2251. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Chris Longhurst (email available below). General contact details of provider: http://www.tandfonline.com/RAEC20 .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.