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Double health insurance coverage and health care utilisation: evidence from quantile regression

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  • Sara Moreira
  • Pedro Pita Barros

Abstract

Double health insurance coverage exists when an individual benefits from more than one health insurance plan at the same time. We examine the impact of such supplementary insurance on the utilisation of doctor consultations in Portugal, taking advantage of institutional features which make double coverage plausibly exogenous. The novelty is that the analysis is carried out for different points of the conditional distribution, not only for its mean location, within the context of count data modelling and without imposing restrictive parametric assumptions. Results indicate that double coverage creates additional utilisation of health care across the whole outcome distribution for both public and private second layers of health insurance coverage but with greater magnitude in the latter group. We unveil that this additional consumption effect is relatively smaller for more frequent users. Copyright © 2010 John Wiley & Sons, Ltd.

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  • Sara Moreira & Pedro Pita Barros, 2010. "Double health insurance coverage and health care utilisation: evidence from quantile regression," Health Economics, John Wiley & Sons, Ltd., vol. 19(9), pages 1075-1092, September.
    • Handle: RePEc:wly:hlthec:v:19:y:2010:i:9:p:1075-1092
    DOI: 10.1002/hec.1641
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    References listed on IDEAS

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    1. Sara Moreira, 2009. "Double Coverage and Health Care Utilisation:Evidence from Quantile Regression," Working Papers w200911, Banco de Portugal, Economics and Research Department.
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    2. Masayoshi Hayashi, 2011. "The effects of medical factors on transfer deficits in Public Assistance in Japan: a quantile regression analysis," International Journal of Health Economics and Management, Springer, vol. 11(4), pages 287-307, December.
    3. Spitzer, Sonja & Shaikh, Mujaheed, 2022. "Health misperception and healthcare utilisation among older Europeans," The Journal of the Economics of Ageing, Elsevier, vol. 22(C).
    4. Sonja Spitzer & Mujaheed Shaikh, 2020. "Health Misperception and Healthcare Utilisation among Older Europeans," VID Working Papers 2001, Vienna Institute of Demography (VID) of the Austrian Academy of Sciences in Vienna.
    5. Lavaste, Konsta, 2023. "Private health insurance in the universal public healthcare system: The role of healthcare provision in Finland," Health Policy, Elsevier, vol. 132(C).
    6. Aida Isabel Tavares & Inês Marques, 2021. "Multi-layer health insurance coverage, medical services use and health in a Universal National Health System, the case of Portugal," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 22(1), pages 141-153, February.
    7. Søgaard, Rikke & Pedersen, Morten Saaby & Bech, Mickael, 2013. "To what extent does employer-paid health insurance reduce the use of public hospitals?," Health Policy, Elsevier, vol. 113(1), pages 61-68.
    8. Paolo Frumento & Nicola Salvati, 2021. "Parametric modeling of quantile regression coefficient functions with count data," Statistical Methods & Applications, Springer;Società Italiana di Statistica, vol. 30(4), pages 1237-1258, October.

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