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Estimating transition probabilities between health states using US longitudinal survey data

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  • Juergen Jung

    (Towson University)

Abstract

We use data from two representative US household surveys, the Medical Expenditure Panel Survey (MEPS) and the Health and Retirement Study (RAND-HRS) to estimate transition probability matrices between health states over the lifecycle from age 20–95. We compare nonparametric counting methods and parametric methods where we control for individual characteristics as well as time and cohort effects. We align two year transition probabilities from HRS with one-year transition probabilities in MEPS using a stochastic root method assuming a Markov structure. We find that the nonparametric counting method and the regression specifications based on ordered logit models produce similar results over the lifecycle. However, the counting method overestimates the probabilities of transitioning into bad health states. In addition, we find that young women have worse health prospects than their male counterparts but once individuals get older, being female is associated with transitioning into better health states with higher probabilities than men. We do not find significant differences of the conditional health transition probabilities between African Americans and the rest of the population. We also find that the lifecycle patterns are stable over time. Finally, we discuss issues with controlling for time effects, sample attrition, the Markov assumption, and other modeling issues that can arise with categorical outcome variables.

Suggested Citation

  • Juergen Jung, 2022. "Estimating transition probabilities between health states using US longitudinal survey data," Empirical Economics, Springer, vol. 63(2), pages 901-943, August.
  • Handle: RePEc:spr:empeco:v:63:y:2022:i:2:d:10.1007_s00181-021-02157-6
    DOI: 10.1007/s00181-021-02157-6
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    as
    1. Halliday, Timothy & Mazumder, Bhashkar & Wong, Ashley, 2021. "Intergenerational mobility in self-reported health status in the US," Journal of Public Economics, Elsevier, vol. 193(C).
    2. John Fitzgerald & Peter Gottschalk & Robert Moffitt, 1998. "An Analysis of Sample Attrition in Panel Data: The Michigan Panel Study of Income Dynamics," Journal of Human Resources, University of Wisconsin Press, vol. 33(2), pages 251-299.
    3. Deaton, Angus S & Paxson, Christina H, 1998. "Aging and Inequality in Income and Health," American Economic Review, American Economic Association, vol. 88(2), pages 248-253, May.
    4. Jagpreet Chhatwal & Suren Jayasuriya & Elamin H. Elbasha, 2016. "Changing Cycle Lengths in State-Transition Models," Medical Decision Making, , vol. 36(8), pages 952-964, November.
    5. Paul Contoyannis & Andrew M. Jones & Nigel Rice, 2004. "The dynamics of health in the British Household Panel Survey," Journal of Applied Econometrics, John Wiley & Sons, Ltd., vol. 19(4), pages 473-503.
    6. Carl-Johan Dalgaard & Holger Strulik, 2014. "Optimal Aging And Death: Understanding The Preston Curve," Journal of the European Economic Association, European Economic Association, vol. 12(3), pages 672-701, June.
    7. Balia, Silvia & Jones, Andrew M., 2008. "Mortality, lifestyle and socio-economic status," Journal of Health Economics, Elsevier, vol. 27(1), pages 1-26, January.
    8. Mariacristina De Nardi & Eric French & John B. Jones, 2010. "Why Do the Elderly Save? The Role of Medical Expenses," Journal of Political Economy, University of Chicago Press, vol. 118(1), pages 39-75, February.
    9. Marcel Kerkhofs & Maarten Lindeboom, 1995. "Subjective health measures and state dependent reporting errors," Health Economics, John Wiley & Sons, Ltd., vol. 4(3), pages 221-235, May.
    10. Silvia Balia, 2014. "Survival expectations, subjective health and smoking: evidence from SHARE," Empirical Economics, Springer, vol. 47(2), pages 753-780, September.
    11. Contoyannis, Paul & Jones, Andrew M., 2004. "Socio-economic status, health and lifestyle," Journal of Health Economics, Elsevier, vol. 23(5), pages 965-995, September.
    12. Eric French & John Bailey Jones, 2011. "The Effects of Health Insurance and Self‐Insurance on Retirement Behavior," Econometrica, Econometric Society, vol. 79(3), pages 693-732, May.
    13. Nicolas R. Ziebarth, 2009. "Measurement of Health, the Sensitivity of the Concentration Index, and Reporting Heterogeneity," SOEPpapers on Multidisciplinary Panel Data Research 211, DIW Berlin, The German Socio-Economic Panel (SOEP).
    14. S. Rao Aiyagari, 1994. "Uninsured Idiosyncratic Risk and Aggregate Saving," The Quarterly Journal of Economics, Oxford University Press, vol. 109(3), pages 659-684.
    15. Christopher J. Ruhm, 2000. "Are Recessions Good for Your Health?," The Quarterly Journal of Economics, Oxford University Press, vol. 115(2), pages 617-650.
    16. Adam Wagstaff & Eddy Van Doorslaer, 1994. "Measuring inequalities in health in the presence of multiple‐category morbidity indicators," Health Economics, John Wiley & Sons, Ltd., vol. 3(4), pages 281-291, July.
    17. Eric French, 2005. "The Effects of Health, Wealth, and Wages on Labour Supply and Retirement Behaviour," Review of Economic Studies, Oxford University Press, vol. 72(2), pages 395-427.
    18. Lindeboom, Maarten & van Doorslaer, Eddy, 2004. "Cut-point shift and index shift in self-reported health," Journal of Health Economics, Elsevier, vol. 23(6), pages 1083-1099, November.
    19. Timothy J. Halliday & Bhashkar Mazumder & Ashley Wong, 2020. "The intergenerational transmission of health in the United States: A latent variables analysis," Health Economics, John Wiley & Sons, Ltd., vol. 29(3), pages 367-381, March.
    20. Greg Kaplan, 2012. "Inequality and the life cycle," Quantitative Economics, Econometric Society, vol. 3(3), pages 471-525, November.
    21. 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.
    22. Small, Kenneth A & Hsiao, Cheng, 1985. "Multinomial Logit Specification Tests," International Economic Review, Department of Economics, University of Pennsylvania and Osaka University Institute of Social and Economic Research Association, vol. 26(3), pages 619-627, October.
    23. F. Thomas Juster & Richard Suzman, 1995. "An Overview of the Health and Retirement Study," Journal of Human Resources, University of Wisconsin Press, vol. 30, pages 7-56.
    24. Robert B. Wallace & A. Regula Herzog, 1995. "Overview of the Health Measures in the Health and Retirement Study," Journal of Human Resources, University of Wisconsin Press, vol. 30, pages 84-107.
    25. Svetlana Pashchenko & Ponpoje Porapakkarm, 2013. "Quantitative Analysis of Health Insurance Reform: Separating Regulation from Redistribution," Review of Economic Dynamics, Elsevier for the Society for Economic Dynamics, vol. 16(3), pages 383-404, July.
    26. Jung, Juergen & Tran, Chung & Chambers, Matthew, 2017. "Aging and health financing in the U.S.: A general equilibrium analysis," European Economic Review, Elsevier, vol. 100(C), pages 428-462.
    27. Robert B. Israel & Jeffrey S. Rosenthal & Jason Z. Wei, 2001. "Finding Generators for Markov Chains via Empirical Transition Matrices, with Applications to Credit Ratings," Mathematical Finance, Wiley Blackwell, vol. 11(2), pages 245-265, April.
    28. Erik Meijer & Arie Kapteyn & Tatiana Andreyeva, 2011. "Internationally comparable health indices," Health Economics, John Wiley & Sons, Ltd., vol. 20(5), pages 600-619, May.
    29. Vijverberg, Wim P., 2011. "Testing for IIA with the Hausman-McFadden Test," IZA Discussion Papers 5826, Institute of Labor Economics (IZA).
    30. Becketti, Sean & Gould, William & Lillard, Lee & Welch, Finis, 1988. "The Panel Study of Income Dynamics after Fourteen Years: An Evaluatio n," Journal of Labor Economics, University of Chicago Press, vol. 6(4), pages 472-492, October.
    31. Doorslaer, Eddy van & Jones, Andrew M., 2003. "Inequalities in self-reported health: validation of a new approach to measurement," Journal of Health Economics, Elsevier, vol. 22(1), pages 61-87, January.
    32. Juergen Jung & Chung Tran, 2016. "Market Inefficiency, Insurance Mandate and Welfare: U.S. Health Care Reform 2010," Review of Economic Dynamics, Elsevier for the Society for Economic Dynamics, vol. 20, pages 132-159, April.
    33. Huggett, Mark, 1993. "The risk-free rate in heterogeneous-agent incomplete-insurance economies," Journal of Economic Dynamics and Control, Elsevier, vol. 17(5-6), pages 953-969.
    34. Juergen Jung & Chung Tran, 2014. "Medical consumption over the life-cycle," Empirical Economics, Springer, vol. 47(3), pages 927-957, November.
    35. Lee A. Lillard & Constantijn W. A. Panis, 1998. "Panel Attrition from the Panel Study of Income Dynamics: Household Income, Marital Status, and Mortality," Journal of Human Resources, University of Wisconsin Press, vol. 33(2), pages 437-457.
    36. Honggao Cao & Daniel H. Hill, 2005. "Active versus Passive Sample Attrition: The Health and Retirement Study," Econometrics 0505006, University Library of Munich, Germany.
    37. Ridder, Geert, 1992. "An empirical evaluation of some models for non-random attrition in panel data," Structural Change and Economic Dynamics, Elsevier, vol. 3(2), pages 337-355, December.
    38. Svetlana Pashchenko & Ponpoje Porapakkarm, 2013. "Quantitative Analysis of Health Insurance Reform: Separating Regulation from Redistribution," Review of Economic Dynamics, Elsevier for the Society for Economic Dynamics, vol. 16(3), pages 383-404, July.
    39. Selahattin Imrohoroglu & Sagiri Kitao, 2012. "Social Security Reforms: Benefit Claiming, Labor Force Participation, and Long-Run Sustainability," American Economic Journal: Macroeconomics, American Economic Association, vol. 4(3), pages 96-127, July.
    40. 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.
    41. Maryaline Catillon & David Cutler & Thomas Getzen, 2018. "Two Hundred Years of Health and Medical Care: The Importance of Medical Care for Life Expectancy Gains," NBER Working Papers 25330, National Bureau of Economic Research, Inc.
    42. Grossman, Michael, 2000. "The human capital model," Handbook of Health Economics, in: A. J. Culyer & J. P. Newhouse (ed.), Handbook of Health Economics, edition 1, volume 1, chapter 7, pages 347-408, Elsevier.
    43. 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, February.
    44. Gerdtham, U. -G. & Johannesson, M. & Lundberg, L. & Isacson, D., 1999. "A note on validating Wagstaff and van Doorslaer's health measure in the analysis of inequalities in health," Journal of Health Economics, Elsevier, vol. 18(1), pages 117-124, January.
    45. Hausman, Jerry A & Wise, David A, 1979. "Attrition Bias in Experimental and Panel Data: The Gary Income Maintenance Experiment," Econometrica, Econometric Society, vol. 47(2), pages 455-473, March.
    46. Juergen Jung & Chung Tran, 2016. "Market Inefficiency, Insurance Mandate and Welfare: U.S. Health Care Reform 2010," Review of Economic Dynamics, Elsevier for the Society for Economic Dynamics, vol. 20, pages 132-159, April.
    47. Crossley, Thomas F. & Kennedy, Steven, 2002. "The reliability of self-assessed health status," Journal of Health Economics, Elsevier, vol. 21(4), pages 643-658, July.
    48. Maarten Lindeboom & Marcel Kerkhofs, 2009. "Health and work of the elderly: subjective health measures, reporting errors and endogeneity in the relationship between health and work," Journal of Applied Econometrics, John Wiley & Sons, Ltd., vol. 24(6), pages 1024-1046.
    49. Michael G. Palumbo, 1999. "Uncertain Medical Expenses and Precautionary Saving Near the End of the Life Cycle," Review of Economic Studies, Oxford University Press, vol. 66(2), pages 395-421.
    50. Wilde, Joachim, 2000. "Identification of multiple equation probit models with endogenous dummy regressors," Economics Letters, Elsevier, vol. 69(3), pages 309-312, December.
    51. Ziebarth, Nicolas, 2010. "Measurement of health, health inequality, and reporting heterogeneity," Social Science & Medicine, Elsevier, vol. 71(1), pages 116-124, July.
    52. Philip M. Clarke & Chris Ryan, 2006. "Self‐reported health: reliability and consequences for health inequality measurement," Health Economics, John Wiley & Sons, Ltd., vol. 15(6), pages 645-652, June.
    53. Imrohoroglu, Ayse & Imrohoroglu, Selahattin & Joines, Douglas H, 1995. "A Life Cycle Analysis of Social Security," Economic Theory, Springer;Society for the Advancement of Economic Theory (SAET), vol. 6(1), pages 83-114, June.
    54. Kakwani, Nanak & Wagstaff, Adam & van Doorslaer, Eddy, 1997. "Socioeconomic inequalities in health: Measurement, computation, and statistical inference," Journal of Econometrics, Elsevier, vol. 77(1), pages 87-103, March.
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    More about this item

    Keywords

    Lifecycle profiles of health transition probabilities; Medical expenditure panel survey (MEPS); Health and retirement study (RAND-HRS); Health transition matrices; Conditional health transition probabilities; Markov property; Age-time-cohort effects;
    All these keywords.

    JEL classification:

    • I10 - Health, Education, and Welfare - - Health - - - General
    • C14 - Mathematical and Quantitative Methods - - Econometric and Statistical Methods and Methodology: General - - - Semiparametric and Nonparametric Methods: General
    • C23 - Mathematical and Quantitative Methods - - Single Equation Models; Single Variables - - - Models with Panel Data; Spatio-temporal Models
    • C25 - Mathematical and Quantitative Methods - - Single Equation Models; Single Variables - - - Discrete Regression and Qualitative Choice Models; Discrete Regressors; Proportions; Probabilities
    • D15 - Microeconomics - - Household Behavior - - - Intertemporal Household Choice; Life Cycle Models and Saving

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