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Latent class models for utilisation of health care

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  • Teresa Bago d'Uva

Abstract

This paper explores different approaches to econometric modelling of count measures of health care utilisation, with an emphasis on latent class models. A new model is proposed that combines the features of the two most common approaches: the hurdle model and the finite mixture negative binomial. Additionally, the panel structure of the data is taken into account. The proposed finite mixture hurdle model is shown to fit the data substantially better than the existing models for a particular application to data from the RAND Health Insurance Experiment. The estimation results indicate a higher price effect for low users of health care. It is furthermore found that this results mainly from the difference of the price effects on the probability to visit a doctor, while the price effect on the conditional number of visits does not differ significantly between high and low users. Copyright © 2006 John Wiley & Sons, Ltd.

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File URL: http://hdl.handle.net/10.1002/hec.1112
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Bibliographic Info

Article provided by John Wiley & Sons, Ltd. in its journal Health Economics.

Volume (Year): 15 (2006)
Issue (Month): 4 ()
Pages: 329-343

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Handle: RePEc:wly:hlthec:v:15:y:2006:i:4:p:329-343

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

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Cited by:
  1. Wouterse, Bram & Huisman, Martijn & Meijboom, Bert R. & Deeg, Dorly J.H. & Polder, Johan J., 2013. "Modeling the relationship between health and health care expenditures using a latent Markov model," Journal of Health Economics, Elsevier, Elsevier, vol. 32(2), pages 423-439.
  2. Hole, Arne Risa, 2008. "Modelling heterogeneity in patients' preferences for the attributes of a general practitioner appointment," Journal of Health Economics, Elsevier, Elsevier, vol. 27(4), pages 1078-1094, July.
  3. Munkin M & Trivedi P. K, 2009. "Incentives and Selection Effects of Drug Coverage on Total Drug Expenditure: a Finite Mixture Approach," Health, Econometrics and Data Group (HEDG) Working Papers, HEDG, c/o Department of Economics, University of York 09/22, HEDG, c/o Department of Economics, University of York.
  4. Erik Schokkaert & Tom van Ourti & Diane De Grave & Ann Lecluyse & Carine Van De Voorde, 2007. "Supplemental health insurance and equality of access in Belgium," Center for Economic Studies - Discussion papers, Katholieke Universiteit Leuven, Centrum voor Economische Studiën ces0729, Katholieke Universiteit Leuven, Centrum voor Economische Studiën.
  5. Anne Nolan, 2007. "A dynamic analysis of GP visiting in Ireland: 1995-2001," Health Economics, John Wiley & Sons, Ltd., John Wiley & Sons, Ltd., vol. 16(2), pages 129-143.
  6. Majo, M.C. & Soest, A.H.O. van, 2011. "The Fixed-Effects Zero-Inflated Poisson Model with an Application to Health Care Utilization," Discussion Paper, Tilburg University, Center for Economic Research 2011-083, Tilburg University, Center for Economic Research.
  7. Valerie Albouy & Laurent Davezies & Thierry Debrand, 2009. "Dynamic Estimation of Health Expenditure: A new approach for simulating individual expenditure," Working Papers, IRDES institut for research and information in health economics DT20, IRDES institut for research and information in health economics, revised Jan 2009.
  8. Óscar Lourenço & Carlota Quintal & Pedro Lopes Ferreira & Pedro Pita Barros, 2007. "A equidade na utilização de cuidados de saúde em Portugal: Uma avaliação baseada em modelos de contagem," Notas Económicas, Faculdade de Economia, Universidade de Coimbra, Faculdade de Economia, Universidade de Coimbra, issue 25, pages 6-26, June.
  9. 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, HEDG, c/o Department of Economics, University of York 07/27, HEDG, c/o Department of Economics, University of York.
  10. Michael Keane & Olena Stavrunova, 2011. "A smooth mixture of Tobits model for healthcare expenditure," Health Economics, John Wiley & Sons, Ltd., John Wiley & Sons, Ltd., vol. 20(9), pages 1126-1153, 09.
  11. Kristian Bolin & Anna Lindgren & Bjorn Lindgren & Petter Lundborg, 2008. "Utilisation of Physician Services in the 50+ Population. The Relative Importance of Individual versus Institutional Factors in 10 European Countries," NBER Working Papers 14096, National Bureau of Economic Research, Inc.
  12. Helmut Farbmacher & Peter Ihle & Ingrid Schubert & Joachim Winter & Amelie C. Wuppermann, 2013. "Heterogeneous Effects of a Nonlinear Price Schedule for Outpatient Care," CESifo Working Paper Series 4499, CESifo Group Munich.
  13. Jones, A.M, 2010. "Models For Health Care," Health, Econometrics and Data Group (HEDG) Working Papers, HEDG, c/o Department of Economics, University of York 10/01, HEDG, c/o Department of Economics, University of York.

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