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Beyond catastrophic payments: modeling household health expenditure shares with endogenous selection

Author

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  • Antonello Maruotti

    (LUMSA University)

  • Pierfrancesco Alaimo Di Loro

    (LUMSA University)

  • Cathleen Johnson

    (West Virginia University)

Abstract

The primary purpose of this paper is to assess households’ burden due to out-of-pocket healthcare expenditures. These payments are modeled on a representative sample of 25668 Italian households as the fraction of out-of-pocket healthcare expenditures over the households’ capacity to pay. For this purpose, we propose extending the analysis of the so-called catastrophic payments by looking at the entire distribution of this ratio. We introduce a novel finite mixture regression able to capture different levels of heterogeneity in the data. By using such a model specification, the fairness of the Italian National Health Service and its determinants are investigated.

Suggested Citation

  • Antonello Maruotti & Pierfrancesco Alaimo Di Loro & Cathleen Johnson, 2025. "Beyond catastrophic payments: modeling household health expenditure shares with endogenous selection," AStA Advances in Statistical Analysis, Springer;German Statistical Society, vol. 109(2), pages 363-386, June.
    • Handle: RePEc:spr:alstar:v:109:y:2025:i:2:d:10.1007_s10182-024-00519-w
    DOI: 10.1007/s10182-024-00519-w
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