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An Econometric Model of Healthcare Demand With Nonlinear Pricing

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  • Johannes S. Kunz
  • Rainer Winkelmann

Abstract

From 2004 to 2012, the German social health insurance levied a co‐payment for the first doctor visit in a calendar quarter. We develop a new model for estimating the effect of such a co‐payment on the individual number of visits per quarter. The model combines a one‐time increase in the otherwise constant hazard rate determining the timing of doctor visits with a difference‐in‐differences strategy to identify the reform effect. An extended version of the model accounts for a mismatch between reporting period and calendar quarter. Using data from the German Socio‐Economic Panel, we do not find an effect of the co‐payment on demand for doctor visits. Copyright © 2016 John Wiley & Sons, Ltd.

Suggested Citation

  • Johannes S. Kunz & Rainer Winkelmann, 2017. "An Econometric Model of Healthcare Demand With Nonlinear Pricing," Health Economics, John Wiley & Sons, Ltd., vol. 26(6), pages 691-702, June.
    • Handle: RePEc:wly:hlthec:v:26:y:2017:i:6:p:691-702
    DOI: 10.1002/hec.3343
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    1. Schreyögg, Jonas & Grabka, Markus M., 2010. "Copayments for Ambulatory Care in Germany: A Natural Experiment Using a Difference-in-Difference Approach," EconStor Open Access Articles and Book Chapters, ZBW - Leibniz Information Centre for Economics, vol. 11(3), pages 331-341.
    2. Rainer Winkelmann, 2004. "Health care reform and the number of doctor visits-an econometric analysis," Journal of Applied Econometrics, John Wiley & Sons, Ltd., vol. 19(4), pages 455-472.
    3. Cameron, A Colin & Trivedi, Pravin K, 1986. "Econometric Models Based on Count Data: Comparisons and Applications of Some Estimators and Tests," Journal of Applied Econometrics, John Wiley & Sons, Ltd., vol. 1(1), pages 29-53, January.
    4. Helmut Farbmacher & Joachim Winter, 2013. "Per‐Period Co‐Payments And The Demand For Health Care: Evidence From Survey And Claims Data," Health Economics, John Wiley & Sons, Ltd., vol. 22(9), pages 1111-1123, September.
    5. Mullahy, John, 1986. "Specification and testing of some modified count data models," Journal of Econometrics, Elsevier, vol. 33(3), pages 341-365, December.
    6. Helmut Farbmacher & Peter Ihle & Ingrid Schubert & Joachim Winter & Amelie Wuppermann, 2017. "Heterogeneous Effects of a Nonlinear Price Schedule for Outpatient Care," Health Economics, John Wiley & Sons, Ltd., vol. 26(10), pages 1234-1248, October.
    7. 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.
    8. Augurzky, Boris & Bauer, Thomas K. & Schaffner, Sandra, 2006. "Copayments in the German Health System - Do They Work?," RWI Discussion Papers 43, RWI - Leibniz-Institut für Wirtschaftsforschung.
    9. Gert G. Wagner & Joachim R. Frick & Jürgen Schupp, 2007. "The German Socio-Economic Panel Study (SOEP) – Scope, Evolution and Enhancements," Schmollers Jahrbuch : Journal of Applied Social Science Studies / Zeitschrift für Wirtschafts- und Sozialwissenschaften, Duncker & Humblot, Berlin, vol. 127(1), pages 139-169.
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    Cited by:

    1. Nicole Black & Johannes S. Kunz, 2024. "The Intergenerational Effects of Language Proficiency on Child Health Outcomes: Evidence from Survey- and Census-matched Health Care Records," Papers 2024-11, Centre for Health Economics, Monash University.
    2. David Cantarero-Prieto & Marta Pascual-Sáez & Carla Blázquez-Fernández, 2021. "Does Social Isolation Affect Medical Doctor Visits? New Evidence Among European Older Adults," Applied Research in Quality of Life, Springer;International Society for Quality-of-Life Studies, vol. 16(2), pages 787-804, April.
    3. Johannes S. Kunz & Kevin E. Staub & Rainer Winkelmann, 2021. "Predicting individual effects in fixed effects panel probit models," Journal of the Royal Statistical Society Series A, Royal Statistical Society, vol. 184(3), pages 1109-1145, July.
    4. Stefanie Thönnes, 2019. "Ex-post moral hazard in the health insurance market: empirical evidence from German data," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 20(9), pages 1317-1333, December.
    5. Johansson, Naimi & de New, Sonja C. & Kunz, Johannes S. & Petrie, Dennis & Svensson, Mikael, 2023. "Reductions in out-of-pocket prices and forward-looking moral hazard in health care demand," Journal of Health Economics, Elsevier, vol. 87(C).
    6. Fonseca Morello, Thiago, 2023. "Hospitalization due to fire-induced pollution in the Brazilian Amazon: A causal inference analysis with an assessment of policy trade-offs," World Development, Elsevier, vol. 161(C).
    7. Kunz, J.S.; & Staub, K.E.; & Winkelmann, R.;, 2018. "Predicting fixed effects in panel probit models," Health, Econometrics and Data Group (HEDG) Working Papers 18/23, HEDG, c/o Department of Economics, University of York.
    8. Mingming Xu & Benjamin Bittschi, 2022. "Does the abolition of copayment increase ambulatory care utilization?: a quasi-experimental study in Germany," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 23(8), pages 1319-1328, November.
    9. Nicole Black & Johannes S. Kunz, 2019. "The Intergenerational Effects of Language Proficiency on Child Health Outcomes," Monash Economics Working Papers 05-19, Monash University, Department of Economics.
    10. Haaga, Tapio & Böckerman, Petri & Kortelainen, Mika & Tukiainen, Janne, 2024. "Effects of nurse visit copayment on primary care use: Do low-income households pay the price?," Journal of Health Economics, Elsevier, vol. 94(C).
    11. David Cantarero-Prieto & Marta Pascual-Sáez & Carla Blázquez-Fernández, 2018. "Does social isolation affect medical doctor visits? New evidence among European older adults," Working Papers. Collection B: Regional and sectoral economics 1805, Universidade de Vigo, GEN - Governance and Economics research Network.

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    JEL classification:

    • I10 - Health, Education, and Welfare - - Health - - - General
    • C25 - Mathematical and Quantitative Methods - - Single Equation Models; Single Variables - - - Discrete Regression and Qualitative Choice Models; Discrete Regressors; Proportions; Probabilities

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