Health care utilization and self-assessed health: specification of bivariate models using copulas
The discernment of relevant factors driving health care utilization constitutes one important research topic in Health Economics. This issue is frequently addressed through specification of regression models for health care use (y – often measured by number of doctor visits) including, among other covariates, a measure of self-assessed health (sah). However, the exogeneity of sah has been questioned, due to the possible presence of unobservables influencing y and sah, and because individuals’ health assessments may depend on the quantity of medical care received. This paper circumvents the potential endogeneity of sah and its associated consequences within conventional regression models (namely the need to find valid instruments) by adopting a full information approach, with specification of bivariate regression models for the discrete variables (sah,y). The approach is implemented with copula functions, which enable separate consideration of each variable margin and their dependence structure. Estimation of these models is through maximum likelihood, with cross-section data from the Portuguese National Health Survey of 1998/99. Results indicate that estimates of regression parameters do not vary much between different copula models. The dependence parameter estimate is negative across joint models, which suggests evidence of simultaneity of (sah,y) and
(This abstract was borrowed from another version of this item.)
If you experience problems downloading a file, check if you have the proper application to view it first. In case of further problems read the IDEAS help page. Note that these files are not on the IDEAS site. Please be patient as the files may be large.
As the access to this document is restricted, you may want to look for a different version under "Related research" (further below) or search for a different version of it.
Volume (Year): 41 (2011)
Issue (Month): 2 (October)
|Contact details of provider:|| Web page: http://www.springer.com|
|Order Information:||Web: http://www.springer.com/economics/econometrics/journal/181/PS2|
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.:
- James J. Heckman, 1976. "The Common Structure of Statistical Models of Truncation, Sample Selection and Limited Dependent Variables and a Simple Estimator for Such Models," NBER Chapters, in: Annals of Economic and Social Measurement, Volume 5, number 4, pages 475-492 National Bureau of Economic Research, Inc.
- Ángel Marcos Vera-Hernández, 1999. "Duplicate coverage and demand for health care. The case of Catalonia," Health Economics, John Wiley & Sons, Ltd., vol. 8(7), pages 579-598.
- 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.
- Andrew J. Patton, 2006. "Estimation of multivariate models for time series of possibly different lengths," Journal of Applied Econometrics, John Wiley & Sons, Ltd., vol. 21(2), pages 147-173.
- Wagstaff, Adam, 1986. "The demand for health : Some new empirical evidence," Journal of Health Economics, Elsevier, vol. 5(3), pages 195-233, September.
- Nikolay Nenovsky & S. Statev, 2006. "Introduction," Post-Print halshs-00260898, HAL.
- 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.
- Grossman, Michael, 1972. "On the Concept of Health Capital and the Demand for Health," Journal of Political Economy, University of Chicago Press, vol. 80(2), pages 223-255, March-Apr.
- Óscar Lourenço & Carlota Quintal & Pedro Lopes Ferreira & Pedro Pita Barros, 2007. "A equidade na utilização de cuidados de saúde em Portugal: Uma avaliação baseada em modelos de contagem," Notas Económicas, Faculty of Economics, University of Coimbra, issue 25, pages 6-26, June.
- Windmeijer, F A G & Silva, J M C Santos, 1997.
"Endogeneity in Count Data Models: An Application to Demand for Health Care,"
Journal of Applied Econometrics,
John Wiley & Sons, Ltd., vol. 12(3), pages 281-294, May-June.
- Frank Windmeijer & Joao Santos Silva, 1996. "Endogeneity in count data models; an application to demand for health care," IFS Working Papers W96/15, Institute for Fiscal Studies.
- Rainer Winkelmann, 2002. "Health Care Reform and the Number of Doctor Visits ï¿½ An Econometric Analysis," SOI - Working Papers 0210, Socioeconomic Institute - University of Zurich.
- Teresa Bago d'Uva, 2006.
"Latent class models for utilisation of health care,"
John Wiley & Sons, Ltd., vol. 15(4), pages 329-343.
- Teresa Bago d’Uva, 2005. "Latent class models for utilisation of health care," Health, Econometrics and Data Group (HEDG) Working Papers 05/01, HEDG, c/o Department of Economics, University of York.
- Train,Kenneth E., 2009.
"Discrete Choice Methods with Simulation,"
Cambridge University Press, number 9780521766555, December.
- Muurinen, Jaana-Marja, 1982. "Demand for health: A generalised Grossman model," Journal of Health Economics, Elsevier, vol. 1(1), pages 5-28, May.
- Deb, Partha & Trivedi, Pravin K, 1997. "Demand for Medical Care by the Elderly: A Finite Mixture Approach," Journal of Applied Econometrics, John Wiley & Sons, Ltd., vol. 12(3), pages 313-336, May-June.
- Denuit, Michel & Lambert, Philippe, 2005. "Constraints on concordance measures in bivariate discrete data," Journal of Multivariate Analysis, Elsevier, vol. 93(1), pages 40-57, March.
- Adam Wagstaff, 1987.
"Econometric studies in health economics: a survey of the British literature,"
032chedp, Centre for Health Economics, University of York.
- Wagstaff, Adam, 1989. "Econometric studies in health economics : A survey of the British literature," Journal of Health Economics, Elsevier, vol. 8(1), pages 1-51, March.
- Bénédicte Vidaillet & V. D'Estaintot & P. Abécassis, 2005. "Introduction," Post-Print hal-00287137, HAL.
- Bhat, Chandra R., 2001. "Quasi-random maximum simulated likelihood estimation of the mixed multinomial logit model," Transportation Research Part B: Methodological, Elsevier, vol. 35(7), pages 677-693, August.
- Diane Dancer & Anu Rammohan & Murray D. Smith, 2008. "Infant mortality and child nutrition in Bangladesh," Health Economics, John Wiley & Sons, Ltd., vol. 17(9), pages 1015-1035.
- repec:sae:ecolab:v:16:y:2006:i:2:p:1-2 is not listed on IDEAS
- Barros, Pedro Pita & Machado, Matilde P. & Sanz-de-Galdeano, Anna, 2008.
"Moral hazard and the demand for health services: A matching estimator approach,"
Journal of Health Economics,
Elsevier, vol. 27(4), pages 1006-1025, July.
- Barros, Pedro Luis Pita & Machado, Matilde Pinto & Sanz-de-Galdeano, Anna, 2006. "Moral Hazard and the Demand for Health Services: A Matching Estimator Approach," CEPR Discussion Papers 5488, C.E.P.R. Discussion Papers.
- Machado, Matilde P. & Sanz-de-Galdeano, Anna & Pita-Barros, Pedro, 2005. "Moral hazard and the demand for health services: a matching estimator approach," UC3M Working papers. Economics we055928, Universidad Carlos III de Madrid. Departamento de Economía.
- Lee, Lung-Fei, 1983. "Generalized Econometric Models with Selectivity," Econometrica, Econometric Society, vol. 51(2), pages 507-512, March.
- Newhouse, Joseph P. & Phelps, Charles E. & Marquis, M. Susan, 1980. "On having your cake and eating it too : Econometric problems in estimating the demand for health services," Journal of Econometrics, Elsevier, vol. 13(3), pages 365-390, August.
- Sisira Sarma & Wayne Simpson, 2006. "A microeconometric analysis of Canadian health care utilization," Health Economics, John Wiley & Sons, Ltd., vol. 15(3), pages 219-239.
- M. Ruth & K. Donaghy & P. Kirshen, 2006. "Introduction," Chapters, in: Regional Climate Change and Variability, chapter 1 Edward Elgar Publishing.
- Bouye, Eric & Durlleman, Valdo & Nikeghbali, Ashkan & Riboulet, Gaël & Roncalli, Thierry, 2000. "Copulas for finance," MPRA Paper 37359, University Library of Munich, Germany.
- Hendrik Jürges, 2007. "True health vs response styles: exploring cross-country differences in self-reported health," Health Economics, John Wiley & Sons, Ltd., vol. 16(2), pages 163-178.
- Casey Quinn, 2007. "The health-economic applications of copulas: methods in applied econometric research," Health, Econometrics and Data Group (HEDG) Working Papers 07/22, HEDG, c/o Department of Economics, University of York.
- Grogger, Jeffrey, 1990. "A simple test for exogeneity in probit, logit, and poisson regression models," Economics Letters, Elsevier, vol. 33(4), pages 329-332, August.
- Zimmer, David M. & Trivedi, Pravin K., 2006. "Using Trivariate Copulas to Model Sample Selection and Treatment Effects: Application to Family Health Care Demand," Journal of Business & Economic Statistics, American Statistical Association, vol. 24, pages 63-76, January.
- van Ophem, Hans, 1999. "A General Method To Estimate Correlated Discrete Random Variables," Econometric Theory, Cambridge University Press, vol. 15(02), pages 228-237, April.
- Casey Quinn, 2007. "Using copulas to estimate reduced-form systems of equations," Health, Econometrics and Data Group (HEDG) Working Papers 07/25, HEDG, c/o Department of Economics, University of York.
When requesting a correction, please mention this item's handle: RePEc:spr:empeco:v:41:y:2011:i:2:p:447-472. See general information about how to correct material in RePEc.
For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: (Sonal Shukla)or (Rebekah McClure)
If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.
If references are entirely missing, you can add them using this form.
If the full references list an item that is present in RePEc, but the system did not link to it, you can help with this form.
If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your profile, as there may be some citations waiting for confirmation.
Please note that corrections may take a couple of weeks to filter through the various RePEc services.