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Bayesian treatment effects due to a subsidized health program: the case of preventive health care utilization in Medellín (Colombia)

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Listed:
  • Andrés Ramírez–Hassan

    (Universidad EAFIT)

  • Rosember Guerra–Urzola

    (Universidad EAFIT)

Abstract

We analyze the treatment effects due to patients’ status, covered or uncovered by the subsidized health program in Medellín (Colombia), on the number of preventive health care visits to physicians. We use a Bayesian endogenous switching model that allows interaction effects as well as endogeneity due to patients’ status. This framework allows the calculation of the posterior distributions of heterogeneous treatment effects and presents Bayesian learning of the covariance between the two potential outcomes, a relevant policy-maker parameter, even though we do not observe individuals in both states at the same time. We found that there are self-selection effects as well as moral hazard, which may imply adverse consequences for the health care system in Colombia.

Suggested Citation

  • Andrés Ramírez–Hassan & Rosember Guerra–Urzola, 2021. "Bayesian treatment effects due to a subsidized health program: the case of preventive health care utilization in Medellín (Colombia)," Empirical Economics, Springer, vol. 60(3), pages 1477-1506, March.
    • Handle: RePEc:spr:empeco:v:60:y:2021:i:3:d:10.1007_s00181-019-01796-0
    DOI: 10.1007/s00181-019-01796-0
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    1. Munkin, Murat K. & Trivedi, Pravin K., 2003. "Bayesian analysis of a self-selection model with multiple outcomes using simulation-based estimation: an application to the demand for healthcare," Journal of Econometrics, Elsevier, vol. 114(2), pages 197-220, June.
    2. Koop, Gary & Poirier, Dale J., 1997. "Learning about the across-regime correlation in switching regression models," Journal of Econometrics, Elsevier, vol. 78(2), pages 217-227, June.
    3. Jacobi, Liana & Wagner, Helga & Frühwirth-Schnatter, Sylvia, 2016. "Bayesian treatment effects models with variable selection for panel outcomes with an application to earnings effects of maternity leave," Journal of Econometrics, Elsevier, vol. 193(1), pages 234-250.
    4. Murray D. Smith, 2003. "Modelling sample selection using Archimedean copulas," Econometrics Journal, Royal Economic Society, vol. 6(1), pages 99-123, June.
    5. Philip Heidelberger & Peter D. Welch, 1983. "Simulation Run Length Control in the Presence of an Initial Transient," Operations Research, INFORMS, vol. 31(6), pages 1109-1144, December.
    6. Nobile, Agostino, 2000. "Comment: Bayesian multinomial probit models with a normalization constraint," Journal of Econometrics, Elsevier, vol. 99(2), pages 335-345, December.
    7. Li, Mingliang & Tobias, Justin, 2008. "Bayesian Analysis of Treatment Effects in an Ordered Potential Outcomes Model," Staff General Research Papers Archive 12429, Iowa State University, Department of Economics.
    8. Munkin, Murat K. & Trivedi, Pravin K., 2008. "Bayesian analysis of the ordered probit model with endogenous selection," Journal of Econometrics, Elsevier, vol. 143(2), pages 334-348, April.
    9. Poirier, Dale J., 1998. "Revising Beliefs In Nonidentified Models," Econometric Theory, Cambridge University Press, vol. 14(4), pages 483-509, August.
    10. Andreas Million & Regina T. Riphahn & Achim Wambach, 2003. "Incentive effects in the demand for health care: a bivariate panel count data estimation," Journal of Applied Econometrics, John Wiley & Sons, Ltd., vol. 18(4), pages 387-405.
    11. McManus, Douglas A., 1992. "How common is identification in parametric models?," Journal of Econometrics, Elsevier, vol. 53(1-3), pages 5-23.
    12. Michelle M. Mello & Sally C. Stearns & Edward C. Norton, 2002. "Do Medicare HMOs still reduce health services use after controlling for selection bias?," Health Economics, John Wiley & Sons, Ltd., vol. 11(4), pages 323-340, June.
    13. Alejandro Gaviria & Carlos Medina & Carolina Mejia, 2006. "Assessing Health Reform in Colombia: From Theory to Practice," Economía Journal, The Latin American and Caribbean Economic Association - LACEA, vol. 0(Fall 2006), pages 29-72, August.
    14. Andrés Ramírez Hassan & Santiago Montoya Blandón, 2019. "Welfare gains of the poor: An endogenous Bayesian approach with spatial random effects," Econometric Reviews, Taylor & Francis Journals, vol. 38(3), pages 301-318, March.
    15. A. D. Roy, 1951. "Some Thoughts On The Distribution Of Earnings," Oxford Economic Papers, Oxford University Press, vol. 3(2), pages 135-146.
    16. Partha Deb & Pravin K. Trivedi, 2006. "Specification and simulated likelihood estimation of a non-normal treatment-outcome model with selection: Application to health care utilization," Econometrics Journal, Royal Economic Society, vol. 9(2), pages 307-331, July.
    17. Alejandro Gaviria & Carlos Medina & Carolina Mejía, 2006. "Evaluating The Impact Of Health Care Reform In Colombia: From Theory To Practice," Documentos CEDE 2647, Universidad de los Andes, Facultad de Economía, CEDE.
    18. 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.
    19. Cardon, James H & Hendel, Igal, 2001. "Asymmetric Information in Health Insurance: Evidence from the National Medical Expenditure Survey," RAND Journal of Economics, The RAND Corporation, vol. 32(3), pages 408-427, Autumn.
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    More about this item

    Keywords

    Endogenous switching; Ordered response; Potential outcome; Subsidized health program; Treatment effects;
    All these keywords.

    JEL classification:

    • C11 - Mathematical and Quantitative Methods - - Econometric and Statistical Methods and Methodology: General - - - Bayesian Analysis: General
    • H51 - Public Economics - - National Government Expenditures and Related Policies - - - Government Expenditures and Health
    • I13 - Health, Education, and Welfare - - Health - - - Health Insurance, Public and Private

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