Income Growth, Price Variation and Health Care Demand: A Mixed Logit Model Applied to Tow-period Comparison in Rural China
1989-2006 is a period of the start and the end of deregulation of Chinese health care sector and of disintegration of rural cooperative insurance system. During this period, the government health policy has turned healthcare providers all alike into profit seeking entities. Face to perverse effects, by 2003, Chinese government begun to restore rural cooperative insurance system. From CHNS data source, we constitute two samples: 89-93 and 04-06 with respectively 2117 and 2594 rural patients surveyed roughly in the same villages in 9 Chinese provinces to compare their health choice behaviors with the evolution of price, income, distance, insurance, age, and regional inequality. Using Mixed Multinomial Logit (MMNL) estimations, we have obtained three main results. First, even in both periods there is clear price effect, in 04-06 it tends to be weaker, and heterogeneity in price preference has increased. This corresponds well the fact that between the two periods price level has significantly increased and price variation reduced. Second, there is a stronger negative distance effect and heterogeneity in 2004-06, while in 89-93 this negative impact was lower and absent for providers farther than 10km. One interpretation is the existence of a substitution effect: when patients have less possibility to discriminate providers by price, they increase their preference in choice by distance. Third, while, wealth effect exists in some choices in 89-93, it becomes absent in 04-06. Explanations may be that one the one hand both supply side and demand side conditions on health care have been improved even, to less extent though, for the poor, and on the other hand, health care is necessary goods and is price inelastic. But meanwhile, we observed catastrophic effect for the poor: the poorer patients have their share of consumption in income more decreased after health care.
|Date of creation:||05 Jan 2011|
|Note:||View the original document on HAL open archive server: https://halshs.archives-ouvertes.fr/halshs-00552192|
|Contact details of provider:|| Web page: https://hal.archives-ouvertes.fr/|
References listed on IDEAS
Please report citation or reference errors to , or , if you are the registered author of the cited work, log in to your RePEc Author Service profile, click on "citations" and make appropriate adjustments.:
- 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.
- Wagstaff, Adam & Lindelow, Magnus & Jun, Gao & Ling, Xu & Juncheng, Qian, 2009.
"Extending health insurance to the rural population: An impact evaluation of China's new cooperative medical scheme,"
Journal of Health Economics,
Elsevier, vol. 28(1), pages 1-19, January.
- Wagstaff, Adam & Lindelow, Magnus & Gao Jun & Xu Ling & Qian Juncheng, 2007. "Extending health insurance to the rural population : an impact evaluation of China's new cooperative medical scheme," Policy Research Working Paper Series 4150, The World Bank.
- Martine AUDIBERT & Xiao Xian HUANG & Jacky MATHONNAT & Aurore PELISSIER & Anning MA, 2010. "The Impact of the New Rural Cooperative Medical Scheme on Activities and Financing of Township Hospitals in Weifang, China," Working Papers 201037, CERDI.
- Xiao Xian Huang & Aurore Pelissier & Martine Audibert & Jacky Mathonnat & Ningshan Chen & Anning Ma, 2011. "The Impact of the New Rural Cooperative Medical Scheme on Activities and Financing of Township Hospitals in Weifang, China," Working Papers halshs-00553318, HAL.
- 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.
- Paul J. Gertler & Luis Locay & Warren C. Sanderson, 1987. "Are User Fees Regressive? The Welfare Implications of Health Care Financing Proposals in Peru," NBER Working Papers 2299, National Bureau of Economic Research, Inc.
- Patrick Royston, 2004. "Multiple imputation of missing values," Stata Journal, StataCorp LP, vol. 4(3), pages 227-241, September.
- Magnus Lindelow, 2004. "The Utilization of Curative Health Care in Mozambique: Does Income Matter?," CSAE Working Paper Series 2004-11, Centre for the Study of African Economies, University of Oxford.
- 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.
- Arne Risa Hole, 2007. "Modelling Heterogeneity in Patients' Preferences for the Attributes of a General Practitioner Appointment," Working Papers 022cherp, Centre for Health Economics, University of York.
- 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.
- Philip H. Brown & Caroline Theoharides, 2009. "Health‐seeking behavior and hospital choice in China's New Cooperative Medical System," Health Economics, John Wiley & Sons, Ltd., vol. 18(S2), pages 47-64, July.
- 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.
- 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, 05.
- Koc, Cagatay, 2004. "A theoretical rationale for an inelastic demand for health care," Economics Letters, Elsevier, vol. 82(1), pages 9-14, January.
- Magnus Lindelow, 2004. "The Utilization of Curative Health Care in Mozambique: Does Income Matter?," Development and Comp Systems 0409057, EconWPA.
- Canaviri, Jose, 2007. "A Random Parameter Logit model for modeling Health Care Provider Choice in Bolivia," MPRA Paper 3263, University Library of Munich, Germany.
- Yip, Winnie & Hsiao, William, 2009. "China's health care reform: A tentative assessment," China Economic Review, Elsevier, vol. 20(4), pages 613-619, December.
- 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.
- David Revelt & Kenneth Train, 1998. "Mixed Logit With Repeated Choices: Households' Choices Of Appliance Efficiency Level," The Review of Economics and Statistics, MIT Press, vol. 80(4), pages 647-657, November.
- Akin, John S, et al, 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. Full references (including those not matched with items on IDEAS)
When requesting a correction, please mention this item's handle: RePEc:hal:wpaper:halshs-00552192. 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: (CCSD)
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 references are entirely missing, you can add them using this form.
If the full references list an item that is present in RePEc, but the system did not link 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 profile, as there may be some citations waiting for confirmation.
Please note that corrections may take a couple of weeks to filter through the various RePEc services.