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Measuring horizontal inequity in Belgian health care using a Gaussian random effects two part count data model

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Tom Van Ourti

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Abstract

We estimate the determinants of utilisation of physician and hospital services in Belgium using a one- and two-part panel count data model, and a one- and two-part pooled count data model. We conclude that the two-part panel count data model is most appropriate as it controls for unobserved heterogeneity and allows for a two-part decision-making process. The estimates of the determinants of utilisation of health care are then used to calculate indices of horizontal inequity. We find that inequity for general practitioner and hospital services is stable across time and in favour of low-income individuals, in the sense that, overall, they consume more than one would expect on the basis of their need, albeit the indices for hospital care are not significant. Horizontal equity applies to specialist care in all years, but from 1999 onwards, some evidence (although not statistically significant) of pro-rich inequity is found. Copyright © 2004 John Wiley & Sons, Ltd.

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File URL: http://hdl.handle.net/10.1002/hec.920
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Article provided by John Wiley & Sons, Ltd. in its journal Health Economics.

Volume (Year): 13 (2004)
Issue (Month): 7 ()
Pages: 705-724
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Handle: RePEc:wly:hlthec:v:13:y:2004:i:7:p:705-724

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Web page: http://www3.interscience.wiley.com/cgi-bin/jhome/5749

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Please report citation or reference errors to , or , if you are the registered author of the cited work, log in to your RePEc Author Service profile, click on "citations" and make appropriate adjustments.:
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  2. Hugh Gravelle, 2003. "Measuring income related inequality in health: standardisation and the partial concentration index," Health Economics, John Wiley & Sons, Ltd., vol. 12(10), pages 803-819. [Downloadable!]
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  9. Van Ourti T., 2002. "Measuring horizontal inequity in health care using Belgian panel data," Working Papers 2002034, University of Antwerp, Faculty of Applied Economics. [Downloadable!]
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Cited by:
(explanations, Please report citation or reference errors to , or , if you are the registered author of the cited work, log in to your RePEc Author Service profile, click on "citations" and make appropriate adjustments.)

  1. Teresa Bago d'Uva & Andrew M. Jones & Eddy van Doorslaer, 2007. "Measurement of Horizontal Inequity in Health Care Utilisation using European Panel Data," Tinbergen Institute Discussion Papers 07-059/3, Tinbergen Institute. [Downloadable!]
    Other versions:
  2. José M. R. Murteira & Óscar D. Lourenço, 2007. "Health Care Utilization and Self-Assessed Health Specification of Bivariate Models Using Copulas," Health, Econometrics and Data Group (HEDG) Working Papers 07/27, HEDG, c/o Department of Economics, University of York. [Downloadable!]
  3. Ignacio Abásolo & Jaime Pinilla & Miguel Negrín, 2008. "Equity in the utilization of public health care services by regions in Spain: a multinivel analysis," Hacienda Pública Española, IEF, vol. 187(4), pages 87-106, December. [Downloadable!]
  4. Eddy van Doorslaer & Andrew M. Jones, 2004. "Income-related inequality in health and health care in the European Union," Health Economics, John Wiley & Sons, Ltd., vol. 13(7), pages 605-608. [Downloadable!]
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