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Cut-point Shift and Index Shift in Self-reported Health

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Author Info
Maarten Lindeboom () (FEWEB, Vrije Universiteit Amsterdam, and IZA)
Eddy van Doorslaer () (Dept of Health & Management, Erasmus University Rotterdam)

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Abstract

There is a concern that ordered responses on health questions may differ across populations or even across subgroups of a population. This reporting heterogeneity may invalidate group comparisons and measures of health inequality. This paper proposes a test for differential reporting in ordered response models which allows us to distinguish between cut-point shift and index shift. The method is illustrated using Canadian National Population Health Survey data. The McMaster Health Utility Index (HUI) is used as a more objective health measure than the simple 5-point scale of self-assessed health. We find clear evidence of index shifting and cut-point shifting for age and gender, but not for income, education or language.

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Publisher Info
Paper provided by Tinbergen Institute in its series Tinbergen Institute Discussion Papers with number 03-042/3.

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Date of creation: 09 Jun 2003
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Handle: RePEc:dgr:uvatin:20030042

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Web page: http://www.tinbergen.nl/

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Related research
Keywords: health measurement; ordered response models; cut point shift; index shift; Canada.;

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Find related papers by JEL classification:
D30 - Microeconomics - - Distribution - - - General
D31 - Microeconomics - - Distribution - - - Personal Income and Wealth Distribution
I10 - Health, Education, and Welfare - - Health - - - General
I12 - Health, Education, and Welfare - - Health - - - Health Production

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  1. Crossley, Thomas F. & Kennedy, Steven, 2002. "The reliability of self-assessed health status," Journal of Health Economics, Elsevier, vol. 21(4), pages 643-658, July. [Downloadable!] (restricted)
  2. Doorslaer, Eddy van & Jones, Andrew M., 2003. "Inequalities in self-reported health: validation of a new approach to measurement," Journal of Health Economics, Elsevier, vol. 22(1), pages 61-87, January. [Downloadable!] (restricted)
  3. van Doorslaer, Eddy & Wagstaff, Adam & Bleichrodt, Han & Calonge, Samuel & Gerdtham, Ulf-G. & Gerfin, Michael & Geurts, Jose & Gross, Lorna & Hakkinen, Unto & Leu, Robert E., 1997. "Income-related inequalities in health: some international comparisons," Journal of Health Economics, Elsevier, vol. 16(1), pages 93-112, February. [Downloadable!] (restricted)
  4. Groot, Wim, 2000. "Adaptation and scale of reference bias in self-assessments of quality of life," Journal of Health Economics, Elsevier, vol. 19(3), pages 403-420, May. [Downloadable!] (restricted)
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