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Measurement of horizontal inequity in health care utilisation using European Panel data

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  • Teresa Bago d’Uva
  • Andrew M. Jones
  • Eddy van Doorslaer

Abstract

This paper analyzes the effect of dental insurance on utilization of general dentist services by adult US population aged from 25 to 64 years. Our econometric framework accommdates endogeneity of insurance and the ordered nature of the measure of dental utilization. The study finds strong evidence of endogeneity of dental insurance to utilization and identifies interesting patterns of nonlinear dependencies between the dental insurance status and individual’s age and income. The calculated average treatment effect supports the claim of adverse selection into the treated (insured) state and indicates a strong positive incentives effect of dental insurance.

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Bibliographic Info

Paper provided by HEDG, c/o Department of Economics, University of York in its series Health, Econometrics and Data Group (HEDG) Working Papers with number 07/17.

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Date of creation: Aug 2007
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Handle: RePEc:yor:hectdg:07/17

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Postal: HEDG/HERC, Department of Economics and Related Studies, University of York, York, YO10 5DD, United Kingdom
Phone: (0)1904 323776
Fax: (0)1904 323759
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Web page: http://www.york.ac.uk/res/herc/research/hedg/
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Keywords: Inequality; inequity; health care utilisation; panel data; ECHP;

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References

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  1. Wagstaff, Adam & Paci, Pierella & van Doorslaer, Eddy, 1991. "On the measurement of inequalities in health," Social Science & Medicine, Elsevier, vol. 33(5), pages 545-557, January.
  2. Bago d'Uva, Teresa & Jones, Andrew M., 2009. "Health care utilisation in Europe: New evidence from the ECHP," Journal of Health Economics, Elsevier, vol. 28(2), pages 265-279, March.
  3. Andrew Clark & Fabrice Etilé, 2003. "Don't Give up on me Baby: Spousal Correlation in Smoking Behaviour," DELTA Working Papers 2003-25, DELTA (Ecole normale supérieure).
  4. Schokkaert, Erik & Van de Voorde, Carine, 2004. "Risk selection and the specification of the conventional risk adjustment formula," Journal of Health Economics, Elsevier, vol. 23(6), pages 1237-1259, November.
  5. Andrew M. Jones & Angel López, 2003. "Measurement and Explanation of Socioeconomic Inequality in Health with Longitudinal Data," Working Papers 35, Barcelona Graduate School of Economics.
  6. van Doorslaer, Eddy & Wagstaff, Adam & van der Burg, Hattem & Christiansen, Terkel & De Graeve, Diana & Duchesne, Inge & Gerdtham, Ulf-G & Gerfin, Michael & Geurts, Jose & Gross, Lorna, 2000. "Equity in the delivery of health care in Europe and the US," Journal of Health Economics, Elsevier, vol. 19(5), pages 553-583, September.
  7. Matthew Sutton, 2002. "Vertical and horizontal aspects of socio-economic inequity in general practitioner contacts in Scotland," Health Economics, John Wiley & Sons, Ltd., vol. 11(6), pages 537-549.
  8. Tom Van Ourti, 2004. "Measuring horizontal inequity in Belgian health care using a Gaussian random effects two part count data model," Health Economics, John Wiley & Sons, Ltd., vol. 13(7), pages 705-724.
  9. Sergi Jiménez-Mart�n & José M. Labeaga & Maite Mart�nez-Granado, 2002. "Latent class versus two-part models in the demand for physician services across the European Union," Health Economics, John Wiley & Sons, Ltd., vol. 11(4), pages 301-321.
  10. Eddy van Doorslaer & Xander Koolman & Andrew M. Jones, 2004. "Explaining income-related inequalities in doctor utilisation in Europe," Health Economics, John Wiley & Sons, Ltd., vol. 13(7), pages 629-647.
  11. Gerdtham, Ulf-G. & Trivedi, Pravin K., 2000. "Equity in Swedish Health Care Reconsidered: New Results based on the Finite Mixture Model," Working Paper Series in Economics and Finance 365, Stockholm School of Economics.
  12. Hugh Gravelle, 2003. "Measuring income related inequality in health: standardisation and the partial concentration index," Health Economics, John Wiley & Sons, Ltd., vol. 12(10), pages 803-819.
  13. Adam Wagstaff & Eddy van Doorslaer, 2000. "Measuring and Testing for Inequity in the Delivery of Health Care," Journal of Human Resources, University of Wisconsin Press, vol. 35(4), pages 716-733.
  14. Hernández-Quevedo, Cristina & Jones, Andrew M. & López-Nicolás, Angel & Rice, Nigel, 2006. "Socioeconomic inequalities in health: A comparative longitudinal analysis using the European Community Household Panel," Social Science & Medicine, Elsevier, vol. 63(5), pages 1246-1261, September.
  15. Williams, Alan & Cookson, Richard, 2000. "Equity in health," Handbook of Health Economics, in: A. J. Culyer & J. P. Newhouse (ed.), Handbook of Health Economics, edition 1, volume 1, chapter 35, pages 1863-1910 Elsevier.
  16. Wagstaff, Adam & van Doorslaer, Eddy, 2000. "Chapter 34 Equity in health care finance and delivery," Handbook of Health Economics, in: A. J. Culyer & J. P. Newhouse (ed.), Handbook of Health Economics, edition 1, volume 1, chapter 34, pages 1803-1862 Elsevier.
  17. Kakwani, Nanak & Wagstaff, Adam & van Doorslaer, Eddy, 1997. "Socioeconomic inequalities in health: Measurement, computation, and statistical inference," Journal of Econometrics, Elsevier, vol. 77(1), pages 87-103, March.
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Citations

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Cited by:
  1. Teresa Bago d'Uva & Maarten Lindeboom & Owen O'Donnell & Eddy van Doorslaer, 2010. "Education-related Inequity in Health Care with Heterogeneous Reporting of Health," Tinbergen Institute Discussion Papers 10-122/3, Tinbergen Institute.
  2. Hoeck, Sarah & François, Guido & Van der Heyden, Johan & Geerts, Joanna & Van Hal, Guido, 2011. "Healthcare utilisation among the Belgian elderly in relation to their socio-economic status," Health Policy, Elsevier, vol. 99(2), pages 174-182, February.
  3. Ellen van de Poel & Eddy van Doorslaer & Owen O'Donnell, 2011. "Measurement of Inequity in Health Care with Heterogeneous Response of Use to Need," Tinbergen Institute Discussion Papers 11-155/3, Tinbergen Institute.
  4. Mauro Laudicella & Richard Cookson & Andrew Jones & Nigel Rice, 2007. "Health care deprivation profiles in the measurement of inequality and inequity: an application to GP fundholding in the English NHS," Health, Econometrics and Data Group (HEDG) Working Papers 07/28, HEDG, c/o Department of Economics, University of York.
  5. FLEURBAEY, Marc & SCHOKKAERT, Erik, 2011. "Equity in health and health care," CORE Discussion Papers 2011026, Université catholique de Louvain, Center for Operations Research and Econometrics (CORE).
  6. Janoes, A; & Rice, N; & Robone, S; & Rosa Dias, P;, 2010. "Inequality and Polarisation in Health Systems’ Responsiveness: A Cross-Country Analysis," Health, Econometrics and Data Group (HEDG) Working Papers 10/27, HEDG, c/o Department of Economics, University of York.
  7. Grasdal, Astrid & Monstad, Karin, 2009. "Inequity in the use of physician services in Norway. Changing patterns over time," Working Papers in Economics 05/09, University of Bergen, Department of Economics.
  8. repec:pra:mprapa:16097 is not listed on IDEAS
  9. Samuel L Brilleman & Hugh Gravelle & Sandra Hollinghurst & Sarah Purdy & Chris Salisbury & Frank Windmeijer, 2011. "Keep it Simple? Predicting Primary Health Care Costs with Measures of Morbidity and Multimorbidity," Working Papers 072cherp, Centre for Health Economics, University of York.
  10. Carrieri, V.; & Wuebker, A.;, 2012. "Assessing inequalities in preventive care use in Europe: A special case of health-care inequalities?," Health, Econometrics and Data Group (HEDG) Working Papers 12/25, HEDG, c/o Department of Economics, University of York.
  11. Vincenzo Carrieri & Ansgar Wübker, 2012. "Assessing Inequalities in Preventive Care Use in Europe," Ruhr Economic Papers 0371, Rheinisch-Westfälisches Institut für Wirtschaftsforschung, Ruhr-Universität Bochum, Universität Dortmund, Universität Duisburg-Essen.

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