IDEAS home Printed from https://ideas.repec.org/p/cdi/wpaper/1450.html
   My bibliography  Save this paper

Two-Period Comparison of Healthcare Demand with Income Growth and Population Aging in Rural China: Implications for Adjustment of the Healthcare Supply and Development

Author

Listed:
  • Jacky MATHONNAT

    (Centre d'Etudes et de Recherches sur le Développement International(CERDI))

  • Yong HE

    (Centre d'Etudes et de Recherches sur le Développement International(CERDI))

  • Martine AUDIBERT

    (Centre d'Etudes et de Recherches sur le Développement International(CERDI))

Abstract

We estimate the evolution of healthcare demand under the influence of income growth and population aging with two samples of patients surveyed in the same regions, but with an interval of 18 years in rural China and with mixed logit to deal with heterogeneity. In accordance with theoretical and inductive inferences, it is found that healthcare price effects decreased and became more heterogeneous. Aging impact overweighed income growth impact, resulting in increasing distance effect and patients’ preference to proximity. In the face of this demand change, the adjustment of governmental supply should be to promote small and middle-sized healthcare providers. However during this period to cope with urbanization, the Chinese policy consisted of privileging large hospitals. This has led to a higher share of patients, especially the aging patients, to choose self-care and a higher share of poorer patients to suffer from catastrophic health expenditures. This finding carries broad implications for rural health policy-making on, along with income growth, population aging and urbanization, how to provide better coverage of rural areas by enough qualified and multifunctional small and middle-sized healthcare providers in the developing world.

Suggested Citation

  • Jacky MATHONNAT & Yong HE & Martine AUDIBERT, 2013. "Two-Period Comparison of Healthcare Demand with Income Growth and Population Aging in Rural China: Implications for Adjustment of the Healthcare Supply and Development," Working Papers 201315, CERDI.
  • Handle: RePEc:cdi:wpaper:1450
    as

    Download full text from publisher

    File URL: http://publi.cerdi.org/ed/2013/2013.15.pdf
    Download Restriction: no
    ---><---

    Other versions of this item:

    References listed on IDEAS

    as
    1. Mariko, Mamadou, 2003. "Quality of care and the demand for health services in Bamako, Mali: the specific roles of structural, process, and outcome components," Social Science & Medicine, Elsevier, vol. 56(6), pages 1183-1196, March.
    2. Koc, Cagatay, 2004. "A theoretical rationale for an inelastic demand for health care," Economics Letters, Elsevier, vol. 82(1), pages 9-14, January.
    3. Magnus Lindelow, 2005. "The Utilisation of Curative Healthcare in Mozambique: Does Income Matter?," Journal of African Economies, Centre for the Study of African Economies (CSAE), vol. 14(3), pages 435-482, September.
    4. Train,Kenneth E., 2009. "Discrete Choice Methods with Simulation," Cambridge Books, Cambridge University Press, number 9780521766555, October.
    5. Gertler, Paul & Glewwe, Paul, 1990. "The willingness to pay for education in developing countries : Evidence from rural Peru," Journal of Public Economics, Elsevier, vol. 42(3), pages 251-275, August.
    6. Canaviri, Jose, 2007. "A Random Parameter Logit model for modeling Health Care Provider Choice in Bolivia," MPRA Paper 3263, University Library of Munich, Germany.
    7. Yip, Winnie & Hsiao, William, 2009. "China's health care reform: A tentative assessment," China Economic Review, Elsevier, vol. 20(4), pages 613-619, December.
    8. Bijan J. Borah, 2006. "A mixed logit model of health care provider choice: analysis of NSS data for rural India," Health Economics, John Wiley & Sons, Ltd., vol. 15(9), pages 915-932, September.
    9. Gertler, Paul & Locay, Luis & Sanderson, Warren, 1987. "Are user fees regressive? : The welfare implications of health care financing proposals in Peru," Journal of Econometrics, Elsevier, vol. 36(1-2), pages 67-88.
    10. Patrick Royston, 2004. "Multiple imputation of missing values," Stata Journal, StataCorp LP, vol. 4(3), pages 227-241, September.
    11. Victor Lavy and John M. Quigley., 1991. "Willingness to Pay for the Quality and Intensity of Medical Care: Evidence from Low Income Households in Ghana," Economics Working Papers 91-178, University of California at Berkeley.
    12. Sahn, David E. & Stifel, David C., 2000. "Poverty Comparisons Over Time and Across Countries in Africa," World Development, Elsevier, vol. 28(12), pages 2123-2155, December.
    13. Deon Filmer & Kinnon Scott, 2012. "Assessing Asset Indices," Demography, Springer;Population Association of America (PAA), vol. 49(1), pages 359-392, February.
    14. Louviere,Jordan J. & Hensher,David A. & Swait,Joffre D. With contributions by-Name:Adamowicz,Wiktor, 2000. "Stated Choice Methods," Cambridge Books, Cambridge University Press, number 9780521788304.
    15. Lawson, David, 2004. "Determinants of Health Seeking Behaviour in Uganda - Is It Just Income and User Fees That Are Important?," Development Economics and Public Policy Working Papers 30553, University of Manchester, Institute for Development Policy and Management (IDPM).
    16. Richard Herd & Yu-Wei Hu & Vincent Koen, 2010. "Improving China's Health Care System," OECD Economics Department Working Papers 751, OECD Publishing.
    17. Mocan, H. Naci & Tekin, Erdal & Zax, Jeffrey S., 2004. "The Demand for Medical Care in Urban China," World Development, Elsevier, vol. 32(2), pages 289-304, February.
    18. Hole, Arne Risa, 2008. "Modelling heterogeneity in patients' preferences for the attributes of a general practitioner appointment," Journal of Health Economics, Elsevier, vol. 27(4), pages 1078-1094, July.
    19. Akin, John S & Griffin, Charles C & Guilkey, David K & Popkin, Barry M, 1986. "The Demand for Primary Health Care Services in the Bicol Region of the Philippines," Economic Development and Cultural Change, University of Chicago Press, vol. 34(4), pages 755-782, July.
    20. Martine Audibert & Yohana Dukhan & Jacky Mathonnat & Ningshan Chen & Aning Ma & Aïtian Yin, 2008. "Activité et performance des hôpitaux municipaux en Chine rurale. Une analyse sur données d'enquêtes dans la province de Shandong," Revue d’économie du développement, De Boeck Université, vol. 16(1), pages 63-100.
    21. Baltas, George & Doyle, Peter, 2001. "Random utility models in marketing research: a survey," Journal of Business Research, Elsevier, vol. 51(2), pages 115-125, February.
    22. Martine Audibert & Jacky Mathonnat & Yohana Dukhan & Ningshan Chen & Aning Ma & Aïtian Yin, 2008. "Activité et performance des hôpitaux municipaux en Chine rurale. Une analyse sur données d'enquêtes dans la province de Shandong," Post-Print hal-00276226, HAL.
    23. Daniel McFadden & Kenneth Train, 2000. "Mixed MNL models for discrete response," Journal of Applied Econometrics, John Wiley & Sons, Ltd., vol. 15(5), pages 447-470.
    24. David E. Sahn & Stephen D. Younger & Garance Genicot, 2003. "The Demand for Health Care Services in Rural Tanzania," Oxford Bulletin of Economics and Statistics, Department of Economics, University of Oxford, vol. 65(2), pages 241-260, May.
    25. Harris, Katherine M. & Keane, Michael P., 1998. "A model of health plan choice:: Inferring preferences and perceptions from a combination of revealed preference and attitudinal data," Journal of Econometrics, Elsevier, vol. 89(1-2), pages 131-157, November.
    Full references (including those not matched with items on IDEAS)

    Citations

    Blog mentions

    As found by EconAcademics.org, the blog aggregator for Economics research:
    1. #HEJC papers for September 2013
      by academichealtheconomists in The Academic Health Economists' Blog on 2013-09-01 04:01:38

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Martine AUDIBERT & Yong HE & Jacky MATHONNAT, 2017. "What does demand heterogeneity tell us about health care provider choice in rural China?," Working Papers P193, FERDI.
    2. Martine AUDIBERT & Yong HE & Jacky MATHONNAT, 2017. "What does demand heterogeneity tell us about health care provider choice in rural China?," Working Papers P193, FERDI.

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Martine Audibert & Yong He & Jacky Mathonnat, 2013. "Two-Period Comparison of Healthcare Demand with Income Growth and Population Aging in Rural China: Implications for Adjustment of the Healthcare Supply and Development," CERDI Working papers halshs-00846088, HAL.
    2. Martine AUDIBERT & Jacky MATHONNAT & Yong HE, 2010. "Income Growth, Price Variation and Health Care Demand: A Mixed Logit Model Applied to Tow-period Comparison in Rural China," Working Papers 201035, CERDI.
    3. Martine Audibert & Yong He & Jacky Mathonnat, 2011. "Income Growth, Price Variation and Health Care Demand: A Mixed Logit Model Applied to Tow-period Comparison in Rural China," CERDI Working papers halshs-00552192, HAL.
    4. Martine Audibert & Yong He & Jacky Mathonnat, 2013. "Multinomial and Mixed Logit Modeling in the Presence of Heterogeneity: A Two-Period Comparison of Healthcare Provider Choice in Rural China," Working Papers halshs-00846085, HAL.
    5. Martine AUDIBERT & Yong HE & Jacky MATHONNAT, 2017. "What does demand heterogeneity tell us about health care provider choice in rural China?," Working Papers P193, FERDI.
    6. Martine Audibert & Yong He & Jacky Mathonnat, 2013. "Multinomial and Mixed Logit Modeling in the Presence of Heterogeneity: A Two-Period Comparison of Healthcare Provider Choice in Rural China," CERDI Working papers halshs-00846085, HAL.
    7. Martine Audibert & Yong He & Jacky Mathonnat, 2020. "Dealing with Demand Heterogeneity on Health Care Provider Choice – The Case of Rural China," Asian Journal of Economics and Empirical Research, Asian Online Journal Publishing Group, vol. 7(2), pages 258-267.
    8. Martine AUDIBERT & Yong HE & Jacky MATHONNAT, 2017. "What does demand heterogeneity tell us about health care provider choice in rural China?," Working Papers P193, FERDI.
    9. Martine Audibert & Yong He & Jacky Mathonnat, 2020. "Dealing with Demand Heterogeneity on Health Care Provider Choice –The Case of Rural China," Post-Print halshs-02963761, HAL.
    10. Christopher J. Cronin & David K. Guilkey & Ilene S. Speizer, 2019. "Measurement error in discrete health facility choice models: An example from urban Senegal," Journal of Applied Econometrics, John Wiley & Sons, Ltd., vol. 34(7), pages 1102-1120, November.
    11. Kai Shen Lim & Wei Aun Yap & Winnie Yip, 2022. "Consumer choice and public‐private providers: The role of perceived prices," Health Economics, John Wiley & Sons, Ltd., vol. 31(9), pages 1898-1925, September.
    12. Magnus Lindelow, 2003. "Understanding spatial variation in the utilization of health services: does quality matter?," Economics Series Working Papers WPS/2004-12, University of Oxford, Department of Economics.
    13. Alessandro Mengoni & Chiara Seghieri & Sabina Nuti, 2013. "The application of discrete choice experiments in health economics: a systematic review of the literature," Working Papers 201301, Scuola Superiore Sant'Anna of Pisa, Istituto di Management.
    14. Christelle Grobler & Ian C. Stuart, 2007. "Health Care Provider Choice," South African Journal of Economics, Economic Society of South Africa, vol. 75(2), pages 327-350, June.
    15. Supon Limwattananon & Sven Neelsen & Owen O'Donnell & Phusit Prakongsai & Viroj Tangcharoensathien & Eddy van Doorslaer & Vuthiphan Vongmongkol, 2013. "Universal Coverage on a Budget: Impacts on Health Care Utilization and Out-Of-Pocket Expenditures in Thailand," CESifo Working Paper Series 4262, CESifo.
    16. Kjaer, Trine & Gyrd-Hansen, Dorte, 2008. "Preference heterogeneity and choice of cardiac rehabilitation program: Results from a discrete choice experiment," Health Policy, Elsevier, vol. 85(1), pages 124-132, January.
    17. Michael Keane & Nada Wasi, 2013. "Comparing Alternative Models Of Heterogeneity In Consumer Choice Behavior," Journal of Applied Econometrics, John Wiley & Sons, Ltd., vol. 28(6), pages 1018-1045, September.
    18. Haghani, Milad & Bliemer, Michiel C.J. & Hensher, David A., 2021. "The landscape of econometric discrete choice modelling research," Journal of choice modelling, Elsevier, vol. 40(C).
    19. Magnus Lindelow, 2004. "Understanding spatial variation in the utilization of health," Development and Comp Systems 0409058, University Library of Munich, Germany.
    20. Emily Lancsar & Peter Burge, 2014. "Choice modelling research in health economics," Chapters, in: Stephane Hess & Andrew Daly (ed.), Handbook of Choice Modelling, chapter 28, pages 675-687, Edward Elgar Publishing.

    More about this item

    Keywords

    Two-period healthcare demand comparison; Mixed logit model; Price and distance effects; Heterogeneity; Insurance; Rural China;
    All these keywords.

    JEL classification:

    • I1 - Health, Education, and Welfare - - Health
    • C5 - Mathematical and Quantitative Methods - - Econometric Modeling
    • D1 - Microeconomics - - Household Behavior

    NEP fields

    This paper has been announced in the following NEP Reports:

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:cdi:wpaper:1450. See general information about how to correct material in RePEc.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: . General contact details of provider: https://edirc.repec.org/data/ceauvfr.html .

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Vincent Mazenod (email available below). General contact details of provider: https://edirc.repec.org/data/ceauvfr.html .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service hosted by the Research Division of the Federal Reserve Bank of St. Louis . RePEc uses bibliographic data supplied by the respective publishers.