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Inequalities in health care utilization in Spain due to double insurance coverage: An Oaxaca-Ransom decomposition

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  • González Álvarez, M Luz
  • Barranquero, Antonio Clavero

Abstract

In this article, the analysis of inequalities in health care utilization, produced by the taking out of a private health insurance policy to supplement the care provided by the Spanish National Health System, has been performed by the Oaxaca-Ransom decomposition. Using the European Community Household Panel, this method permits the conclusion that the majority of differences in the number of visits to a general practitioner are explained by the individual characteristics of the publicly insured, while the divergences in the number of consultations with specialists are the result of the overuse of this care by the population with double health insurance coverage.

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  • González Álvarez, M Luz & Barranquero, Antonio Clavero, 2009. "Inequalities in health care utilization in Spain due to double insurance coverage: An Oaxaca-Ransom decomposition," Social Science & Medicine, Elsevier, vol. 69(5), pages 793-801, September.
  • Handle: RePEc:eee:socmed:v:69:y:2009:i:5:p:793-801
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    1. 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.
    2. Andrew M. Jones & Angel López Nicolás, 2004. "Measurement and explanation of socioeconomic inequality in health with longitudinal data," Health Economics, John Wiley & Sons, Ltd., vol. 13(10), pages 1015-1030, October.
    3. Fairlie, Robert W., 2003. "An Extension of the Blinder-Oaxaca Decomposition Technique to Logit and Probit Models," Center Discussion Papers 28425, Yale University, Economic Growth Center.
    4. Ulf‐ G. Gerdtham, 1997. "Equity in Health Care Utilization: Further Tests Based on Hurdle Models and Swedish Micro Data," Health Economics, John Wiley & Sons, Ltd., vol. 6(3), pages 303-319, May.
    5. Begoña Álvarez, 2001. "La demanda atendida de consultas médicas y servicios urgentes en España," Investigaciones Economicas, Fundación SEPI, vol. 25(1), pages 93-138, January.
    6. Fairlie, Robert W, 1999. "The Absence of the African-American Owned Business: An Analysis of the Dynamics of Self-Employment," Journal of Labor Economics, University of Chicago Press, vol. 17(1), pages 80-108, January.
    7. Marisol Rodríguez & Alexandrina Stoyanova, 2004. "The effect of private insurance access on the choice of GP/specialist and public/private provider in Spain," Health Economics, John Wiley & Sons, Ltd., vol. 13(7), pages 689-703, July.
    8. Thomas Bauer & Mathias Sinning, 2010. "Blinder-Oaxaca decomposition for Tobit models," Applied Economics, Taylor & Francis Journals, vol. 42(12), pages 1569-1575.
    9. Oaxaca, Ronald, 1973. "Male-Female Wage Differentials in Urban Labor Markets," International Economic Review, Department of Economics, University of Pennsylvania and Osaka University Institute of Social and Economic Research Association, vol. 14(3), pages 693-709, October.
    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, July.
    11. Wagstaff, Adam & van Doorslaer, Eddy & Watanabe, Naoko, 2003. "On decomposing the causes of health sector inequalities with an application to malnutrition inequalities in Vietnam," Journal of Econometrics, Elsevier, vol. 112(1), pages 207-223, January.
    12. Wagstaff, Adam & van Doorslaer, Eddy & Paci, Pierella, 1989. "Equity in the Finance and Delivery of Health Care: Some Tentative Cross-country Comparisons," Oxford Review of Economic Policy, Oxford University Press, vol. 5(1), pages 89-112, Spring.
    13. repec:zbw:rwidps:0032 is not listed on IDEAS
    14. 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.
    15. 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.
    16. Alan S. Blinder, 1973. "Wage Discrimination: Reduced Form and Structural Estimates," Journal of Human Resources, University of Wisconsin Press, vol. 8(4), pages 436-455.
    17. Ignacio Abasolo & Rob Manning & Andrew Jones, 2001. "Equity in utilization of and access to public-sector GPs in Spain," Applied Economics, Taylor & Francis Journals, vol. 33(3), pages 349-364.
    18. repec:adr:anecst:y:2006:i:83-84 is not listed on IDEAS
    19. Mireia Jofre-Bonet, 2000. "Public health care and private insurance demand: The waiting time as a link," Health Care Management Science, Springer, vol. 3(1), pages 51-71, January.
    20. repec:adr:anecst:y:2006:i:83-84:p:10 is not listed on IDEAS
    21. Cotton, Jeremiah, 1988. "On the Decomposition of Wage Differentials," The Review of Economics and Statistics, MIT Press, vol. 70(2), pages 236-243, May.
    22. Reimers, Cordelia W, 1983. "Labor Market Discrimination against Hispanic and Black Men," The Review of Economics and Statistics, MIT Press, vol. 65(4), pages 570-579, November.
    23. Winfried Pohlmeier & Volker Ulrich, 1995. "An Econometric Model of the Two-Part Decisionmaking Process in the Demand for Health Care," Journal of Human Resources, University of Wisconsin Press, vol. 30(2), pages 339-361.
    24. Thomas Bauer & Mathias Sinning, 2008. "An extension of the Blinder–Oaxaca decomposition to nonlinear models," AStA Advances in Statistical Analysis, Springer;German Statistical Society, vol. 92(2), pages 197-206, May.
    25. repec:zbw:rwidps:0049 is not listed on IDEAS
    26. David Neumark, 1988. "Employers' Discriminatory Behavior and the Estimation of Wage Discrimination," Journal of Human Resources, University of Wisconsin Press, vol. 23(3), pages 279-295.
    27. Andrew M. Jones & Xander Koolman & Eddy Van Doorslaer, 2006. "The impact of having supplementary private health insurance on the uses of specialists," Annals of Economics and Statistics, GENES, issue 83-84, pages 251-275.
    28. Oaxaca, Ronald L. & Ransom, Michael R., 1994. "On discrimination and the decomposition of wage differentials," Journal of Econometrics, Elsevier, vol. 61(1), pages 5-21, March.
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