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Health Care Reform and the Number of Doctor Visits - An Econometric Analysis

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Author Info
Winkelmann, Rainer

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Abstract

The Paper evaluates the German health care reform of 1997, using the individual number of doctor visits as outcome measure. A new econometric model, the Probit-Poisson-log-normal model with correlated errors, describes the data better than existing count data models. Moreover, it has an attractive structural interpretation, as it allows the reforms to have a different effect at different parts of the distribution. The overall effect of the reform was a 10% reduction in the number of doctor visits. The effect was much larger in the lower part of the distribution than in the upper part.

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Publisher Info
Paper provided by C.E.P.R. Discussion Papers in its series CEPR Discussion Papers with number 3021.

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Date of creation: Oct 2001
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Handle: RePEc:cpr:ceprdp:3021

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Related research
Keywords: co-payment; count data; moral hazard; probit-Poisson-log-normal model;

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Find related papers by JEL classification:
C25 - Mathematical and Quantitative Methods - - Single Equation Models; Single Variables - - - Discrete Regression and Qualitative Choice Models
I11 - Health, Education, and Welfare - - Health - - - Analysis of Health Care Markets
I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health

References listed on IDEAS
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  1. Deb, Partha & Trivedi, Pravin K., 2002. "The structure of demand for health care: latent class versus two-part models," Journal of Health Economics, Elsevier, vol. 21(4), pages 601-625, July. [Downloadable!] (restricted)
  2. Jose A. F. Machado & J. M. C. Santos Silva, 2002. "Quantiles for counts," CeMMAP working papers CWP22/02, Centre for Microdata Methods and Practice, Institute for Fiscal Studies. [Downloadable!]
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  3. Grossman, Michael, 1972. "On the Concept of Health Capital and the Demand for Health," Journal of Political Economy, University of Chicago Press, vol. 80(2), pages 223-55, March-Apr. [Downloadable!] (restricted)
  4. Santos Silva, J. M. C., 1997. "Unobservables in count data models for on-site samples," Economics Letters, Elsevier, vol. 54(3), pages 217-220, July. [Downloadable!] (restricted)
  5. Mullahy, John, 1986. "Specification and testing of some modified count data models," Journal of Econometrics, Elsevier, vol. 33(3), pages 341-365, December. [Downloadable!] (restricted)
  6. Vuong, Quang H, 1989. "Likelihood Ratio Tests for Model Selection and Non-nested Hypotheses," Econometrica, Econometric Society, vol. 57(2), pages 307-33, March. [Downloadable!] (restricted)
  7. Santos Silva, Joao M. C. & Windmeijer, Frank, 2001. "Two-part multiple spell models for health care demand," Journal of Econometrics, Elsevier, vol. 104(1), pages 67-89, August. [Downloadable!] (restricted)
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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. Rainer Winkelmann, 2003. "Re-evaluating an Evaluation Study: The Case of the German Health Care Reform of 1997," Working Papers 0311, University of Zurich, Socioeconomic Institute. [Downloadable!]
  2. Samuel Muehlemann & Stefan C. Wolter & Jürg Schweri & Rainer Winkelmann, 2007. "An empirical analysis of the decision to train apprentices," Economics of Education Working Paper Series 0005, University of Zurich, Institute for Strategy and Business Economics (ISU). [Downloadable!]
    Other versions:
  3. Michael Gerfin & Martin Schellhorn, 2006. "Nonparametric bounds on the effect of deductibles in health care insurance on doctor visits - Swiss evidence," Health Economics, John Wiley & Sons, Ltd., vol. 15(9), pages 1011-1020. [Downloadable!]
    Other versions:
  4. Sergi Jiménez-Martín & José M. Labeaga & Maite Martínez-Granado, 2003. "An Empirical Analysis of the Demand for Physician Services Across the European Union," Economic Working Papers at Centro de Estudios Andaluces E2003/45, Centro de Estudios Andaluces. [Downloadable!]
  5. 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!]
  6. Lori J. Curtis & William J. MacMinn, 2007. "Health-Care Utilization in Canada: 25 Years of Evidence," Social and Economic Dimensions of an Aging Population Research Papers 190, McMaster University. [Downloadable!]
  7. William Greene, 2007. "Functional Form and Heterogeneity in Models for Count Data," Working Papers 07-10, New York University, Leonard N. Stern School of Business, Department of Economics. [Downloadable!]
  8. Rainer Winkelmann, 2003. "How Did the German Health Care Reform of 1997 Change the Distribution of the Demand for Health Services?," Working Papers 0314, University of Zurich, Socioeconomic Institute. [Downloadable!]
  9. Bruce Headey & Markus M. Grabka, 2004. "The Relationship between Pet Ownership and Health Outcomes: German Longitudinal Evidence," Discussion Papers of DIW Berlin 434, DIW Berlin, German Institute for Economic Research. [Downloadable!]
  10. Samuel Muehlemann & Juerg Schweri & Rainer Winkelmann & Stefan C. Wolter, 2005. "A Structural Model of Demand for Apprentices," CESifo Working Paper Series CESifo Working Paper No. , CESifo Group Munich. [Downloadable!]
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  11. Bettina Isengard & Thorsten Schneider, 2006. "The euro and its perception in the German population," Discussion Papers 011, University of Flensburg, International Institute of Management. [Downloadable!]
  12. Moreira, S & Pita Barros, P, 2009. "Double coverage and demand for health care: Evidence from quantile regression," Health, Econometrics and Data Group (HEDG) Working Papers 09/21, HEDG, c/o Department of Economics, University of York. [Downloadable!]
  13. Matthew Berman & Andrea Fenaughty, 2005. "Technology and managed care: patient benefits of telemedicine in a rural health care network," Health Economics, John Wiley & Sons, Ltd., vol. 14(6), pages 559-573. [Downloadable!]
  14. Hellström, Jörgen & Nordström, Jonas, 2005. "Demand and Welfare Effects in Recreational Travel Models: A Bivariate Count Data Approach," UmeÃ¥ Economic Studies 648, Umeå University, Department of Economics. [Downloadable!]
  15. Teresa Bago d'Uva, 2006. "Latent class models for utilisation of health care," Health Economics, John Wiley & Sons, Ltd., vol. 15(4), pages 329-343. [Downloadable!]
  16. Klaus Moeltner & James J. Murphy & John K. Stranlund & Maria Alejandra Velez, 2007. "Processing Data from Social Dilemma Experiments: A Bayesian Comparison of Parametric Estimators," Working Papers 07-013, University of Nevada, Reno, Department of Economics & University of Nevada, Reno , Department of Resource Economics. [Downloadable!]
  17. Simon Loertscher & Yves Schneider, 2005. "Switching Costs, Firm Size, and Market Structure," Working Papers 0508, University of Zurich, Socioeconomic Institute. [Downloadable!]
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