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The dynamic interdependence in the demand of primary and emergency secondary care: A hidden Markov approach

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  • Laudicella, Mauro

    (University of Southern Denmark, DaCHE - Danish Centre for Health Economics)

  • Li Donni, Paolo

    (University of Palermo, Department of Economics, Business and Statistics)

Abstract

This paper develops an extension of the class of finite mixture models for longitudinal count data to the bivariate case by using a trivariate reduction technique and a hidden Markov chain approach. The model allows for disentangling unobservable time-varying heterogeneity from the dynamic effect of utilisation of primary and secondary care and measuring their potential substitution effect. Three points of supports adequately describe the distribution of the latent states suggesting the existence of three profiles of low, medium and high users who shows persistency in their behaviour, but not permanence as some switch to their neighbour's profile.

Suggested Citation

  • Laudicella, Mauro & Li Donni, Paolo, 2021. "The dynamic interdependence in the demand of primary and emergency secondary care: A hidden Markov approach," DaCHE discussion papers 2021:1, University of Southern Denmark, Dache - Danish Centre for Health Economics.
    • Handle: RePEc:hhs:sduhec:2021_001
    DOI: 10.21996/26m8-5r10
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    Cited by:

    1. Rachet-Jacquet, Laurie & Rocks, Stephen & Charlesworth, Anita, 2023. "Long-term projections of health care funding, bed capacity and workforce needs in England," Health Policy, Elsevier, vol. 132(C).

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    More about this item

    Keywords

    mixture distributions; hidden Markov models; panel data; primary care; secondary care; Denmark healthcare.;
    All these keywords.

    JEL classification:

    • C33 - Mathematical and Quantitative Methods - - Multiple or Simultaneous Equation Models; Multiple Variables - - - Models with Panel Data; Spatio-temporal Models
    • D12 - Microeconomics - - Household Behavior - - - Consumer Economics: Empirical Analysis
    • I11 - Health, Education, and Welfare - - Health - - - Analysis of Health Care Markets
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health

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