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Is magnitude of co-payment effect related to income? Using census data for health services research

Author

Listed:
  • Cherkin, Daniel C.
  • Grothaus, Louis
  • Wagner, Edward H.

Abstract

This study: (1) describes and evaluates a method for estimating household income using home addresses in conjunction with census data, and (2) uses this method in a study designed to determine if the introduction of copayments caused primary care office visit rates to decrease more for lower income enrollees than for higher income enrollees of a large health maintenance organization (HMO). Each step in the process of linking income estimates for small census units (block groups) to specific home addresses is described and the validity and precision of these estimates is assessed through comparisons of estimated income with self-reported income for residents of the Puget Sound area of Washington state. Although subject to considerable measurement error, this approach provided valid income estimates. This method was then used to estimate the incomes of over 20,000 households of HMO enrollees in a controlled study of the relationship between copayment effect on visit rates and enrollee income. Copayments were found to have a similar effect on higher and lower income enrollees.

Suggested Citation

  • Cherkin, Daniel C. & Grothaus, Louis & Wagner, Edward H., 1992. "Is magnitude of co-payment effect related to income? Using census data for health services research," Social Science & Medicine, Elsevier, vol. 34(1), pages 33-41, January.
    • Handle: RePEc:eee:socmed:v:34:y:1992:i:1:p:33-41
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    Cited by:

    1. Martínez Roget, Fidel & Rodríguez González, Xosé Antón, 2005. "Asignación de ayudas públicas mediante ELECTRE-TRI. Una apliación al turismo rural en Galicia/Methodology for the Distribution of Public Aids: a Application for the Rural Tourism in Galicia," Estudios de Economia Aplicada, Estudios de Economia Aplicada, vol. 23, pages 255-278, Abril.
    2. Lostao, Lourdes & Regidor, Enrique & Geyer, Siegfried & Aïach, Pierre, 2007. "Patient cost sharing and social inequalities in access to health care in three western European countries," Social Science & Medicine, Elsevier, vol. 65(2), pages 367-376, July.
    3. Kim, Jiyun & Ko, Sukyoung & Yang, Bongmin, 2005. "The effects of patient cost sharing on ambulatory utilization in South Korea," Health Policy, Elsevier, vol. 72(3), pages 293-300, June.
    4. Astrid Kiil & Kurt Houlberg, 2014. "How does copayment for health care services affect demand, health and redistribution? A systematic review of the empirical evidence from 1990 to 2011," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 15(8), pages 813-828, November.
    5. Vanessa Cirulli & Giuliano Resce & Marco Ventura, 2021. "Co-payment exemption and healthcare consumption. Quasi-experimental evidence from Italy," Working Papers in Public Economics 203, University of Rome La Sapienza, Department of Economics and Law.
    6. Mamas Theodorou, 2014. "Testing the Waters for GeSY: Patients’ Opinion of Cost-sharing Arrangements in the Public Health Care System in Cyprus," Cyprus Economic Policy Review, University of Cyprus, Economics Research Centre, vol. 8(2), pages 37-59, December.
    7. Panagiotis Petrou, 2015. "An Interrupted Time-Series Analysis to Assess Impact of Introduction of Co-Payment on Emergency Room Visits in Cyprus," Applied Health Economics and Health Policy, Springer, vol. 13(5), pages 515-523, October.
    8. Nilsson, Anton & Paul, Alexander, 2018. "Patient cost-sharing, socioeconomic status, and children's health care utilization," Journal of Health Economics, Elsevier, vol. 59(C), pages 109-124.

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