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A microeconometric analysis of Canadian health care utilization

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  • Sisira Sarma
  • Wayne Simpson

Abstract

Understanding health care utilization is important to design efficient and effective health systems. Toward this end, we develop a relatively simple and intutively appealing microeconometric framework to analyse health care utilization and illustrate its use with recent Canadian microdata. We find that health care utilization consists of distinct stochastic processes requiring the use of two stochastic regression models. In particular, the latent class modelling framework is the superior statistical framework if the data permit modelling unobserved heterogeneity and overdispersion. In many instances, results differ for the classes of high and low users of health care services. Copyright © 2005 John Wiley & Sons, Ltd.

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  • 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, March.
    • Handle: RePEc:wly:hlthec:v:15:y:2006:i:3:p:219-239
    DOI: 10.1002/hec.1057
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    Cited by:

    1. Aida Isabel Tavares & Inês Marques, 2021. "Multi-layer health insurance coverage, medical services use and health in a Universal National Health System, the case of Portugal," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 22(1), pages 141-153, February.
    2. Richard Layte & Anne Nolan, 2015. "Eligibility for free GP care and the utilisation of GP services by children in Ireland," International Journal of Health Economics and Management, Springer, vol. 15(1), pages 3-27, March.
    3. Thang Dang, 2022. "Retirement and health services utilization in a low‐income country," Economics of Transition and Institutional Change, John Wiley & Sons, vol. 30(3), pages 597-620, July.
    4. Giuliana Luca & Michela Ponzo & Antonio Andrés, 2013. "Health care utilization by immigrants in Italy," International Journal of Health Economics and Management, Springer, vol. 13(1), pages 1-31, March.
    5. Soumitra Ghosh, 2015. "Socio-economic Patterns in Inpatient Care Utilisation in India: Is the Income Effect Withering?," Margin: The Journal of Applied Economic Research, National Council of Applied Economic Research, vol. 9(1), pages 39-60, February.
    6. Joan Gil & Antoni Sicras-Mainar & Eugenio Zucchelli, 2018. "Uncontrolled diabetes and health care utilisation: panel data evidence from Spain," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 19(6), pages 785-795, July.
    7. Gregori Baetschmann & Rainer Winkelmann, 2012. "Modelling zero-inflated count data when exposure varies: with an application to sick leave," ECON - Working Papers 061, Department of Economics - University of Zurich.
    8. Hudson, Eibhlin & Nolan, Anne, 2015. "Public healthcare eligibility and the utilisation of GP services by older people in Ireland," The Journal of the Economics of Ageing, Elsevier, vol. 6(C), pages 24-43.
    9. Joan Gil & Antonio Sicras-Mainar & Eugenio Zucchelli, 2016. "The effects of non-adherence on health care utilisation: panel data evidence on uncontrolled diabetes," Working Papers 2016-06, FEDEA.
    10. Richard Peter & Sebastian Soika & Petra Steinorth, 2016. "Health Insurance, Health Savings Accounts and Healthcare Utilization," Health Economics, John Wiley & Sons, Ltd., vol. 25(3), pages 357-371, March.
    11. José Murteira & Óscar Lourenço, 2011. "Health care utilization and self-assessed health: specification of bivariate models using copulas," Empirical Economics, Springer, vol. 41(2), pages 447-472, October.
    12. Martine Visser & Frikkie Booysen, 2004. "Determinants of the choice of health care facility utilised by individuals in HIV/AIDS-affected households in the Free State province of South Africa," SALDRU/CSSR Working Papers 087, Southern Africa Labour and Development Research Unit, University of Cape Town.
    13. 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.
    14. Helmut Farbmacher, 2013. "Extensions Of Hurdle Models For Overdispersed Count Data," Health Economics, John Wiley & Sons, Ltd., vol. 22(11), pages 1398-1404, November.
    15. Devlin, Rose Anne & Sarma, Sisira & Zhang, Qi, 2011. "The role of supplemental coverage in a universal health insurance system: Some Canadian evidence," Health Policy, Elsevier, vol. 100(1), pages 81-90, April.
    16. João Cotter Salvado, 2008. "The Determinants of Health Care Utilization in Portugal: An Approach with Count Data Models," Swiss Journal of Economics and Statistics (SJES), Swiss Society of Economics and Statistics (SSES), vol. 144(III), pages 437-458, September.
    17. McLeod, Logan, 2011. "A nonparametric vs. latent class model of general practitioner utilization: Evidence from Canada," Journal of Health Economics, Elsevier, vol. 30(6), pages 1261-1279.
    18. Paulos Teckle & Matt Sutton, 2008. "How Do the Determinants of Demand for GP Visits Respond to Higher Supply? An Analysis of Grouped Counts," Swiss Journal of Economics and Statistics (SJES), Swiss Society of Economics and Statistics (SSES), vol. 144(III), pages 495-513, September.
    19. Galina Besstremyannaya, 2014. "Heterogeneous effect of coinsurance rate on healthcare costs: generalized finite mixtures and matching estimators," Discussion Papers 14-014, Stanford Institute for Economic Policy Research.
    20. Hiroki Wakamatsu & Seiichi Fukui & Kana Miwa, 2019. "Heterogeneous Preferences for Micro Health Insurance Attributes in Rural Cambodia: Latent Class Analysis," Economics Bulletin, AccessEcon, vol. 39(4), pages 2963-2975.
    21. Sarma, Sisira & Basu, Kisalaya & Gupta, Anil, 2007. "The influence of prescription drug insurance on psychotropic and non-psychotropic drug utilization in Canada," Social Science & Medicine, Elsevier, vol. 65(12), pages 2553-2565, December.
    22. Lori J. Curtis & William J. MacMinn, 2008. "Health Care Utilization in Canada: Twenty-five Years of Evidence," Canadian Public Policy, University of Toronto Press, vol. 34(1), pages 65-88, March.
    23. Gerald Manthalu, 2019. "User fee exemption and maternal health care utilisation at mission health facilities in Malawi: An application of disequilibrium theory of demand and supply," Health Economics, John Wiley & Sons, Ltd., vol. 28(4), pages 461-474, April.

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