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Fairness of the national health service in Italy: a bivariate correlated random effects model

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  • Antonello Maruotti

Abstract

The primary purpose of this paper is to comprehensively assess households' burden due to health payments. Starting from the fairness approach developed by the World Health Organization, we analyse the burden of healthcare payments on Italian households by modeling catastrophic payments and impoverishment due to healthcare expenditures. For this purpose, we propose to extend the analysis of fairness in financing contribution through a generalized linear mixed models by introducing a bivariate correlated random effects model, where association between the outcomes is modeled through individual- and outcome-specific latent effects which are assumed to be correlated. We discuss model parameter estimation in a finite mixture context. By using such model specification, the fairness of the Italian national health service is investigated.

Suggested Citation

  • Antonello Maruotti, 2009. "Fairness of the national health service in Italy: a bivariate correlated random effects model," Journal of Applied Statistics, Taylor & Francis Journals, vol. 36(7), pages 709-722.
    • Handle: RePEc:taf:japsta:v:36:y:2009:i:7:p:709-722
    DOI: 10.1080/02664760802499311
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    References listed on IDEAS

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    1. 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.
    2. 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.
    3. Davidson, Russell & MacKinnon, James G., 1993. "Estimation and Inference in Econometrics," OUP Catalogue, Oxford University Press, number 9780195060119.
    4. Massimo Filippini & Diego Lunati & Luca Crivelli, 2001. "Dimensione ottima degli ospedali in uno Stato federale," ECONOMIA PUBBLICA, FrancoAngeli Editore, vol. 2001(5).
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    1. Samuel López-López & Raúl del Pozo-Rubio & Marta Ortega-Ortega & Francisco Escribano-Sotos, 2021. "Catastrophic Household Expenditure Associated with Out-of-Pocket Healthcare Payments in Spain," IJERPH, MDPI, vol. 18(3), pages 1-18, January.
    2. Dimitris Zavras, 2021. "Feeling Uncertainty during the Lockdown That Commenced in March 2020 in Greece," IJERPH, MDPI, vol. 18(10), pages 1-10, May.
    3. 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.
    4. Maria-Carmen García-Centeno & Román Mínguez-Salido & Raúl del Pozo-Rubio, 2021. "The Classification of Profiles of Financial Catastrophe Caused by Out-of-Pocket Payments: A Methodological Approach," Mathematics, MDPI, vol. 9(11), pages 1-20, May.
    5. Yerramilli, Pooja & Fernández, Óscar & Thomson, Sarah, 2018. "Financial protection in Europe: a systematic review of the literature and mapping of data availability," Health Policy, Elsevier, vol. 122(5), pages 493-508.
    6. Aleksandra Kolasa & Ewa Weychert, 2024. "The causal effect of catastrophic health expenditure on poverty in Poland," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 25(2), pages 193-206, March.

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