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A microeconometric analysis of Canadian health care utilization

Author

Listed:
  • Sisira Sarma

    (Elisabeth Bruyere Research Institute, Ottawa, Canada)

  • Wayne Simpson

    (Department of Economics, University of Manitoba, Winnipeg, Canada)

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.

Suggested Citation

  • 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.
  • Handle: RePEc:wly:hlthec:v:15:y:2006:i:3:p:219-239
    DOI: 10.1002/hec.1057
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    File URL: http://hdl.handle.net/10.1002/hec.1057
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    References listed on IDEAS

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    1. Manning, W. G. & Duan, N. & Rogers, W. H., 1987. "Monte Carlo evidence on the choice between sample selection and two-part models," Journal of Econometrics, Elsevier, vol. 35(1), pages 59-82, May.
    2. Wagstaff, Adam, 1986. "The demand for health : Some new empirical evidence," Journal of Health Economics, Elsevier, vol. 5(3), pages 195-233, September.
    3. 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.
    4. Mullahy, John, 1986. "Specification and testing of some modified count data models," Journal of Econometrics, Elsevier, vol. 33(3), pages 341-365, December.
    5. 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.
    6. Andrew M. Jones, 2012. "health econometrics," The New Palgrave Dictionary of Economics, Palgrave Macmillan.
    7. 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.
    8. Mark Stabile, 2001. "Private insurance subsidies and public health care markets: evidence from Canada," Canadian Journal of Economics, Canadian Economics Association, vol. 34(4), pages 921-942, November.
    9. Rune Sørensen & Jostein Grytten, 2000. "Contract design for primary care physicians: Physician location and practice behaviour in small communities," Health Care Management Science, Springer, vol. 3(2), pages 151-157, February.
    10. Gerdtham, Ulf-G. & Johannesson, Magnus, 1999. "New estimates of the demand for health: results based on a categorical health measure and Swedish micro data," Social Science & Medicine, Elsevier, vol. 49(10), pages 1325-1332, November.
    11. A. C. Cameron & P. K. Trivedi & Frank Milne & J. Piggott, 1988. "A Microeconometric Model of the Demand for Health Care and Health Insurance in Australia," Review of Economic Studies, Oxford University Press, vol. 55(1), pages 85-106.
    12. Carlsen, Fredrik & Grytten, Jostein, 2000. "Consumer satisfaction and supplier induced demand," Journal of Health Economics, Elsevier, vol. 19(5), pages 731-753, September.
    13. De Jaegher, Kris & Jegers, Marc, 2000. "A model of physician behaviour with demand inducement," Journal of Health Economics, Elsevier, vol. 19(2), pages 231-258, March.
    14. Kajal Lahiri & Guibo Xing, 2004. "An econometric analysis of veterans’ health care utilization using two-part models," Empirical Economics, Springer, vol. 29(2), pages 431-449, May.
    15. Santos Silva, Joao M. C. & Windmeijer, Frank, 2001. "Two-part multiple spell models for health care demand," Journal of Econometrics, Elsevier, vol. 104(1), pages 67-89, August.
    16. Ulf- G. Gerdtham, 1997. "Equity in Health Care Utilization: Further Tests Based on Hurdle Models and Swedish Micro Data," Health Economics, John Wiley & Sons, Ltd., vol. 6(3), pages 303-319.
    17. Vuong, Quang H, 1989. "Likelihood Ratio Tests for Model Selection and Non-nested Hypotheses," Econometrica, Econometric Society, vol. 57(2), pages 307-333, March.
    18. Gurmu, Shiferaw & Trivedi, Pravin K, 1996. "Excess Zeros in Count Models for Recreational Trips," Journal of Business & Economic Statistics, American Statistical Association, vol. 14(4), pages 469-477, October.
    19. 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.
    20. 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.
    21. Muurinen, Jaana-Marja, 1982. "Demand for health: A generalised Grossman model," Journal of Health Economics, Elsevier, vol. 1(1), pages 5-28, May.
    22. Michael Grossman, 1972. "The Demand for Health: A Theoretical and Empirical Investigation," NBER Books, National Bureau of Economic Research, Inc, number gros72-1, July.
    23. Gerdtham, U. -G. & Johannesson, M. & Lundberg, L. & Isacson, D., 1999. "The demand for health: results from new measures of health capital," European Journal of Political Economy, Elsevier, vol. 15(3), pages 501-521, September.
    24. Zweifel, Peter & Manning, Willard G., 2000. "Moral hazard and consumer incentives in health care," Handbook of Health Economics,in: A. J. Culyer & J. P. Newhouse (ed.), Handbook of Health Economics, edition 1, volume 1, chapter 8, pages 409-459 Elsevier.
    25. Winfried Pohlmeier & Volker Ulrich, 1995. "An Econometric Model of the Two-Part Decisionmaking Process in the Demand for Health Care," Journal of Human Resources, University of Wisconsin Press, vol. 30(2), pages 339-361.
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    Cited by:

    1. 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.
    2. 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.
    3. 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.
    4. 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.
    5. 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.
    6. 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.
    7. 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.
    8. 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.
    9. 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.
    10. repec:eee:joecag:v:6:y:2015:i:c:p:24-43 is not listed on IDEAS
    11. 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.
    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. 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.
    14. 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.
    15. 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.

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