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Exploiting subjective information to understand impoverished children's use of health care

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  • Álvarez, Begoña
  • Vera-Hernández, Marcos

Abstract

Understanding what drives households to seek medical services is challenging because the factors affecting the perceived benefits and costs of professional health care can be the same. In this paper, we disentangle the channels through which different factors affect the use of medical services, whether through perceived benefits and/or costs. We do this by exploiting data on why individuals have not visited a health care professional. Amongst a sample of impoverished Colombian households, we find that health knowledge reduces the use of medical services through decreasing mothers’ perceived benefits of seeking professional care for ill children; birth parity, distance to health facilities and violent shocks all decrease medical care use due to increasing the perceived costs; and education decreases both the perceived benefits and costs, with no overall effect on use. We propose two specification tests, both of which our model passes, as well as a series of robustness checks.

Suggested Citation

  • Álvarez, Begoña & Vera-Hernández, Marcos, 2013. "Exploiting subjective information to understand impoverished children's use of health care," Journal of Health Economics, Elsevier, vol. 32(6), pages 1194-1204.
  • Handle: RePEc:eee:jhecon:v:32:y:2013:i:6:p:1194-1204
    DOI: 10.1016/j.jhealeco.2013.09.008
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    as
    1. John Strauss & Duncan Thomas, 1998. "Health, Nutrition, and Economic Development," Journal of Economic Literature, American Economic Association, vol. 36(2), pages 766-817, June.
    2. Katja Maria Kaufmann, 2014. "Understanding the income gradient in college attendance in Mexico: The role of heterogeneity in expected returns," Quantitative Economics, Econometric Society, vol. 5(3), pages 583-630, November.
    3. Jere R. Behrman & Mark R. Rosenzweig, 2002. "Does Increasing Women's Schooling Raise the Schooling of the Next Generation?," American Economic Review, American Economic Association, vol. 92(1), pages 323-334, March.
    4. Orazio P. Attanasio, 2009. "Expectations and Perceptions in Developing Countries: Their Measurement and Their Use," American Economic Review, American Economic Association, vol. 99(2), pages 87-92, May.
    5. Thomas, Duncan & Lavy, Victor & Strauss, John, 1996. "Public policy and anthropometric outcomes in the Cote d'Ivoire," Journal of Public Economics, Elsevier, vol. 61(2), pages 155-192, August.
    6. J. Dominitz & C. F. Manski, "undated". "Perceptions of Economic Insecurity: Evidence from the Survey of Economic Expectations," Institute for Research on Poverty Discussion Papers 1105-96, University of Wisconsin Institute for Research on Poverty.
    7. Katja Kaufmann & Luigi Pistaferri, 2009. "Disentangling Insurance and Information in Intertemporal Consumption Choices," American Economic Review, American Economic Association, vol. 99(2), pages 387-392, May.
    8. Emanuela Galasso & Nithin Umapathi, 2009. "Improving nutritional status through behavioural change: lessons from Madagascar," Journal of Development Effectiveness, Taylor & Francis Journals, vol. 1(1), pages 60-85.
    9. Alessandro Tarozzi & Aprajit Mahajan, 2011. "Time Inconsistency, Expectations and Technology Adoption: The Case of Insecticide Treated Nets," Working Papers 11-14, Duke University, Department of Economics.
    10. Wagstaff, Adam, 2003. "Child health on a dollar a day: some tentative cross-country comparisons," Social Science & Medicine, Elsevier, vol. 57(9), pages 1529-1538, November.
    11. Andrew M. Jones, 2012. "health econometrics," The New Palgrave Dictionary of Economics,, Palgrave Macmillan.
    12. Michael D. Hurd & Kathleen McGarry, 2002. "The Predictive Validity of Subjective Probabilities of Survival," Economic Journal, Royal Economic Society, vol. 112(482), pages 966-985, October.
    13. Delavande, Adeline & Giné, Xavier & McKenzie, David, 2011. "Measuring subjective expectations in developing countries: A critical review and new evidence," Journal of Development Economics, Elsevier, vol. 94(2), pages 151-163, March.
    14. Rachel Griffith & Lars Nesheim, 2008. "Household willingness to pay for organic products," CeMMAP working papers CWP18/08, Centre for Microdata Methods and Practice, Institute for Fiscal Studies.
    15. Emla Fitzsimons & Bansi Malde & Alice Mesnard & Marcos Vera-Hernandez, 2012. "Household responses to information on child nutrition: experimental evidence from Malawi," IFS Working Papers W12/07, Institute for Fiscal Studies.
    16. Abhijit Banerjee & Angus Deaton & Esther Duflo, 2004. "Wealth, Health, and Health Services in Rural Rajasthan," American Economic Review, American Economic Association, vol. 94(2), pages 326-330, May.
    17. Alderman, Harold & Lavy, Victor, 1996. "Household Responses to Public Health Services: Cost and Quality Tradeoffs," The World Bank Research Observer, World Bank, vol. 11(1), pages 3-22, February.
    18. Wendy Carlin & Mark Schaffer & Paul Seabright, 2006. "Where are the Real Bottlenecks? A Lagrangian Approach to Identifying Constraints on Growth from Subjective Survey Data," CERT Discussion Papers 0604, Centre for Economic Reform and Transformation, Heriot Watt University.
    19. Adeline Delavande, 2008. "Pill, Patch, Or Shot? Subjective Expectations And Birth Control Choice," International Economic Review, Department of Economics, University of Pennsylvania and Osaka University Institute of Social and Economic Research Association, vol. 49(3), pages 999-1042, August.
    20. Charles F. Manski, 2004. "Measuring Expectations," Econometrica, Econometric Society, vol. 72(5), pages 1329-1376, September.
    21. Linnemayr, Sebastian & Alderman, Harold, 2011. "Almost random: Evaluating a large-scale randomized nutrition program in the presence of crossover," Journal of Development Economics, Elsevier, vol. 96(1), pages 106-114, September.
    22. Adeline Delavande & Hans-Peter Kohler, 2009. "Subjective expectations in the context of HIV/AIDS in Malawi," Demographic Research, Max Planck Institute for Demographic Research, Rostock, Germany, vol. 20(31), pages 817-875.
    23. Ariel Fiszbein & Norbert Schady & Francisco H.G. Ferreira & Margaret Grosh & Niall Keleher & Pedro Olinto & Emmanuel Skoufias, 2009. "Conditional Cash Transfers : Reducing Present and Future Poverty," World Bank Publications - Books, The World Bank Group, number 2597, December.
    24. Edgeworth, Ross & Collins, Andrew E., 2006. "Self-care as a response to diarrhoea in rural Bangladesh: Empowered choice or enforced adoption?," Social Science & Medicine, Elsevier, vol. 63(10), pages 2686-2697, November.
    25. Duncan Thomas & John Strauss & Maria-Helena Henriques, 1991. "How Does Mother's Education Affect Child Height?," Journal of Human Resources, University of Wisconsin Press, vol. 26(2), pages 183-211.
    26. Alderman, Harold, 2007. "Improving Nutrition through Community Growth Promotion: Longitudinal Study of the Nutrition and Early Child Development Program in Uganda," World Development, Elsevier, vol. 35(8), pages 1376-1389, August.
    27. Jens Bonke & Martin Browning, 2011. "Spending on Children: Direct Survey Evidence," Economic Journal, Royal Economic Society, vol. 121(554), pages 123-143, August.
    28. Paul Glewwe, 1999. "Why Does Mother's Schooling Raise Child Health in Developing Countries? Evidence from Morocco," Journal of Human Resources, University of Wisconsin Press, vol. 34(1), pages 124-159.
    29. Robert Jensen, 2010. "The (Perceived) Returns to Education and the Demand for Schooling," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 125(2), pages 515-548.
    30. Marini, Alessandra & Gragnolati, Michele, 2006. "Nonlinear effects of altitude on child growth in Peru : a multilevel analysis," Policy Research Working Paper Series 3823, The World Bank.
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    More about this item

    Keywords

    Identification; Subjective information; Health care use; Child health; Developing country;
    All these keywords.

    JEL classification:

    • D83 - Microeconomics - - Information, Knowledge, and Uncertainty - - - Search; Learning; Information and Knowledge; Communication; Belief; Unawareness
    • I11 - Health, Education, and Welfare - - Health - - - Analysis of Health Care Markets
    • O15 - Economic Development, Innovation, Technological Change, and Growth - - Economic Development - - - Economic Development: Human Resources; Human Development; Income Distribution; Migration

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