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Determinants of Access to Physician Services in Italy: A Latent Class Seemingly Unrelated Probit Approach

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Author Info
Vincenzo Atella () (University of Rome II - Faculty of Economics)
Francesco Brindisi () (Columbia University - Department of Economics, University of Rome II - Faculty of Economics)
Partha Deb () (City University of New York - Department of Economics)
Furio C. Rosati () (UCW Project - University of Rome II - Faculty of Economics)

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Abstract

We examine access to general practitioners, public and private specialists in Italy. We develop a novel model using finite mixtures of probit models that provides a rich and flexible functional form. The mixed distribution is flexible and can accommodate non-normality of response probabilities. The empirical analysis shows that patient behavior can be clustered in two latent classes, and that it changes according to the kind of physician service demanded and the latent class to which the individual belongs. We find that income strongly influences the mix of services. Richer individuals are less likely to seek care from GPs and more likely to seek care from specialists, and especially private specialists. Health status and societal vulnerability are the most important indicators of class membership

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Paper provided by Tor Vergata University, CEIS in its series CEIS Research Paper with number 36.

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Length: 23
Date of creation: 26 Sep 2003
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Handle: RePEc:rtv:ceisrp:36

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Postal: CEIS - Centre for Economic and International Studies - Faculty of Economics - University of Rome "Tor Vergata" - Via Columbia, 2 00133 Roma
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Related research
Keywords: Health Care Demand; Latent Class Models; Probit; Italy;

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Find related papers by JEL classification:
C35 - Mathematical and Quantitative Methods - - Multiple or Simultaneous Equation Models; Multiple Variables - - - Discrete Regression and Qualitative Choice Models

References listed on IDEAS
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. 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. Gerdtham, Ulf-G. & Johannesson, Magnus, 1999. "Income-Related Inequality in Life-Years and Quality-Adjusted Life-Years," Working Paper Series in Economics and Finance 334, Stockholm School of Economics. [Downloadable!]
    Other versions:
  3. John F. Geweke & Michael P. Keane, 1997. "Mixture of normals probit models," Staff Report 237, Federal Reserve Bank of Minneapolis. [Downloadable!]
  4. Wang, Peiming & Cockburn, Iain M & Puterman, Martin L, 1998. "Analysis of Patent Data--A Mixed-Poisson-Regression-Model Approach," Journal of Business & Economic Statistics, American Statistical Association, vol. 16(1), pages 27-41, January.
  5. Shinichi Sakata & Halbert White, 1998. "High Breakdown Point Conditional Dispersion Estimation with Application to S&P 500 Daily Returns Volatility," Econometrica, Econometric Society, vol. 66(3), pages 529-568, May.
  6. Gritz, R. Mark, 1993. "The impact of training on the frequency and duration of employment," Journal of Econometrics, Elsevier, vol. 57(1-3), pages 21-51. [Downloadable!] (restricted)
  7. Propper, Carol, 2000. "The demand for private health care in the UK," Journal of Health Economics, Elsevier, vol. 19(6), pages 855-876, November. [Downloadable!] (restricted)
  8. 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)
  9. Morduch, Jonathan J. & Stern, Hal S., 1997. "Using mixture models to detect sex bias in health outcomes in Bangladesh," Journal of Econometrics, Elsevier, vol. 77(1), pages 259-276, March. [Downloadable!] (restricted)
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  10. Wedel, M, et al, 1993. "A Latent Class Poisson Regression Model for Heterogeneous Count Data," Journal of Applied Econometrics, John Wiley & Sons, Ltd., vol. 8(4), pages 397-411, Oct.-Dec.. [Downloadable!] (restricted)
Full references

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. Teresa Bago d'Uva & Andrew M. Jones & Eddy van Doorslaer, 2007. "Measurement of Horizontal Inequity in Health Care Utilisation using European Panel Data," Tinbergen Institute Discussion Papers 07-059/3, Tinbergen Institute. [Downloadable!]
    Other versions:
  2. Cavalieri, Marina, 2009. "Geographical patterns of unmet health care needs in Italy," MPRA Paper 16097, University Library of Munich, Germany. [Downloadable!]
  3. Óscar D. Lourenço & Pedro L. Ferreira, 2005. "Utilization of public health centres in Portugal: effect of time costs and other determinants. Finite mixture models applied to truncated samples," Health Economics, John Wiley & Sons, Ltd., vol. 14(9), pages 939-953. [Downloadable!]
  4. Teresa Bago d'Uva, 2005. "Latent class models for use of primary care: evidence from a British panel," Health Economics, John Wiley & Sons, Ltd., vol. 14(9), pages 873-892. [Downloadable!]
  5. Eddy van Doorslaer & Andrew M. Jones, 2004. "Income-related inequality in health and health care in the European Union," Health Economics, John Wiley & Sons, Ltd., vol. 13(7), pages 605-608. [Downloadable!]
  6. Silvia Balia, 2007. "Reporting expected longevity and smoking: evidence from the SHARE," Working Paper CRENoS 200705, Centre for North South Economic Research, University of Cagliari and Sassari, Sardinia. [Downloadable!]
    Other versions:
  7. 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!]
  8. George France & Francesco Taroni & Andrea Donatini, 2005. "The Italian health-care system," Health Economics, John Wiley & Sons, Ltd., vol. 14(S1), pages S187-S202. [Downloadable!]
  9. Joan Costa Font & Joan Gil Trasfi, 2005. "Obesity and the Incidence of Chronic Diseases: a Seemingly Unrelated Probit Approach," Working Papers in Economics 137, Universitat de Barcelona. Espai de Recerca en Economia. [Downloadable!]
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