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Health care utilisation in Europe: New evidence from the ECHP

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  • Bago d'Uva, Teresa
  • Jones, Andrew M.

Abstract

The ECHP is used to analyse health care utilisation care in Europe. We estimate a new latent class hurdle model for panel data and compare it with the latent class NegBin model and the standard hurdle model. Latent class specifications outperform the standard hurdle model and the latent class hurdle model reveals income effects that are masked in the NegBin model. For specialist visits, low users are more income elastic than high users and the probability of using care is more income elastic than the conditional number of visits. The effects of income on total use of GPs are mostly negative or insignificant but positive elasticities are found for Austria, Greece and, to a greater extent, Portugal. On the whole, richer individuals tend to use more specialist care, especially in Portugal, Ireland, Finland, Greece and Austria. Features of the health care systems of these countries may contribute to the observed inequities.

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  • 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.
  • Handle: RePEc:eee:jhecon:v:28:y:2009:i:2:p:265-279
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    1. Brown, Sarah & Greene, William H. & Harris, Mark N. & Taylor, Karl, 2015. "An inverse hyperbolic sine heteroskedastic latent class panel tobit model: An application to modelling charitable donations," Economic Modelling, Elsevier, vol. 50(C), pages 228-236.
    2. Luca Stella, 2014. "Living Arrangements in Europe: Whether and Why Paternal Retirement Matters," "Marco Fanno" Working Papers 0177, Dipartimento di Scienze Economiche "Marco Fanno".
    3. Bago d'Uva, Teresa & Jones, Andrew M. & van Doorslaer, Eddy, 2009. "Measurement of horizontal inequity in health care utilisation using European panel data," Journal of Health Economics, Elsevier, vol. 28(2), pages 280-289, March.
    4. Hendrik Schmitz, 2012. "More health care utilization with more insurance coverage? Evidence from a latent class model with German data," Applied Economics, Taylor & Francis Journals, vol. 44(34), pages 4455-4468, December.
    5. Fiva, Jon H. & Hægeland, Torbjørn & Rønning, Marte & Syse, Astri, 2014. "Access to treatment and educational inequalities in cancer survival," Journal of Health Economics, Elsevier, vol. 36(C), pages 98-111.
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    7. Kurt R. Brekke & Tor Helge Holmäs & Karin Monstad & Odd Rune Straume, 2015. "Socioeconomic Status and PhysiciansíTreatment Decisions," NIPE Working Papers 5/2015, NIPE - Universidade do Minho.
    8. Damien Bricard & Florence Jusot, 2012. "Intergenerational transmission of health care habits in France," Post-Print hal-01593803, HAL.
    9. repec:dau:papers:123456789/9715 is not listed on IDEAS
    10. Luca Stella, 2017. "Living arrangements in Europe: whether and why paternal retirement matters," Review of Economics of the Household, Springer, vol. 15(2), pages 497-525, June.
    11. Bíró, Anikó, 2013. "Copayments, gatekeeping, and the utilization of outpatient public and private care at age 50 and above in Europe," Health Policy, Elsevier, vol. 111(1), pages 24-33.
    12. Anikó Bíró, 2014. "Supplementary private health insurance and health care utilization of people aged 50+," Empirical Economics, Springer, vol. 46(2), pages 501-524, March.
    13. García-Gómez, Pilar & Hernández-Quevedo, Cristina & Jiménez-Rubio, Dolores & Oliva-Moreno, Juan, 2015. "Inequity in long-term care use and unmet need: Two sides of the same coin," Journal of Health Economics, Elsevier, vol. 39(C), pages 147-158.
    14. 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.
    15. Sophie Guthmuller & Florence Jusot & Jérôme Wittwer, 2014. "Improving Takeup of Health Insurance Program: A Social Experiment in France," Journal of Human Resources, University of Wisconsin Press, vol. 49(1), pages 167-194.
    16. Sara Moreira & Pedro Pita Barros, 2009. "Double Coverage and Health Care Utilisation:Evidence from Quantile Regression," Working Papers w200911, Banco de Portugal, Economics and Research Department.
    17. 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.
    18. Wouterse, Bram & Huisman, Martijn & Meijboom, Bert R. & Deeg, Dorly J.H. & Polder, Johan J., 2013. "Modeling the relationship between health and health care expenditures using a latent Markov model," Journal of Health Economics, Elsevier, vol. 32(2), pages 423-439.
    19. Brown, Sarah & Greene, William H. & Harris, Mark N., 2014. "A New Formulation for Latent Class Models," IZA Discussion Papers 8283, Institute for the Study of Labor (IZA).
    20. Sara Moreira & Pedro Pita Barros, 2009. "Impact of Double Coverage on the Utilisation of Health Care," Economic Bulletin and Financial Stability Report Articles, Banco de Portugal, Economics and Research Department.
    21. repec:dau:papers:123456789/10720 is not listed on IDEAS
    22. Kairies-Schwarz, Nadja & Kokot, Johanna & Vomhof, Markus & Wessling, Jens, 2014. "How Do Consumers Choose Health Insurance? – An Experiment on Heterogeneity in Attribute Tastes and Risk Preferences," Ruhr Economic Papers 537, RWI - Leibniz-Institut für Wirtschaftsforschung, Ruhr-University Bochum, TU Dortmund University, University of Duisburg-Essen.
    23. Paul Joustra & Reinier Meester & Hans Ophem, 2013. "Can statisticians beat surgeons at the planning of operations?," Empirical Economics, Springer, vol. 44(3), pages 1697-1718, June.
    24. Nadja Kairies-Schwarz & Johanna Kokot & Markus Vomhof & Jens Wessling, 2014. "How Do Consumers Choose Health Insurance? – An Experiment on Heterogeneity in Attribute Tastes and Risk Preferences," Ruhr Economic Papers 0537, Rheinisch-Westfälisches Institut für Wirtschaftsforschung, Ruhr-Universität Bochum, Universität Dortmund, Universität Duisburg-Essen.

    More about this item

    Keywords

    Inequity Health care utilisation Latent class models Hurdle models Panel data;

    JEL classification:

    • C72 - Mathematical and Quantitative Methods - - Game Theory and Bargaining Theory - - - Noncooperative Games
    • D82 - Microeconomics - - Information, Knowledge, and Uncertainty - - - Asymmetric and Private Information; Mechanism Design
    • L14 - Industrial Organization - - Market Structure, Firm Strategy, and Market Performance - - - Transactional Relationships; Contracts and Reputation

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