IDEAS home Printed from
MyIDEAS: Log in (now much improved!) to save this paper

What drives out-of pocket health expenditures of private households? - Empirical evidence from the Austrian household budget survey

Listed author(s):
  • Alice sanwald


  • Engelbert Theurl


Registered author(s):

    Out-of-pocket health expenditures (OOPHE) are a substantial source of health care financing even in health care systems with an established role of prepaid financing. The empirical analysis of OOPHE is challenging, because they are fixed in an interaction with other sources of health care financing. We analyze to what extent a set of socio-economic and socio-demographic covariates of private households in influences the OOPHE-patterns in Austria. Our empirical research strategy is guided by the approach Propper (2000) used to study the demand for private health care in the NHS. We use cross-sectional information provided by the Austrian household budget survey 2009/10. We apply a Two-Part Model (Logit/OLS with log-transformed dependent variable or Logit/GLM). We present results for total OOPHE and for selected OOPHE-subcategories. Overall, we find mixed results for the different expenditure categories and for the two decision stages. Probability and level of OOPHE increase with the household size and the level of education, while household income shows mixed results on both stages. Private health insurance and OOPHE seem to be complements, at least for total OOPHE and for OOPHE for physician services, while this relationship is insignificant for pharmaceuticals. Different forms of public insurance have an effect on the total OOPHE-level, for physician services and pharmaceuticals on both stages. To some extent the participation decision is influenced in a different way compared to the intensity decision. This is especially true for age, sex, household structure and the status of retirement. It turns out, that the explanatory power of the used variables is low for OOPHE for pharmaceuticals. A splitting up of pharmaceuticals into prescription fees and direct payments gives better insights into the determinants. We conclude: It is necessary to investigate subcategories of OOPHE. It also turns out, that systematic covariates explain only a very small part of the variation in the OOPHE-patterns. Finally, we also conclude that information on OOPHE from general household budget surveys are of limited value when studying the determinants.

    If you experience problems downloading a file, check if you have the proper application to view it first. In case of further problems read the IDEAS help page. Note that these files are not on the IDEAS site. Please be patient as the files may be large.

    File URL:
    Download Restriction: no

    Paper provided by Faculty of Economics and Statistics, University of Innsbruck in its series Working Papers with number 2014-04.

    in new window

    Length: 38
    Date of creation: Feb 2014
    Handle: RePEc:inn:wpaper:2014-04
    Contact details of provider: Postal:
    Universitätsstraße 15, A - 6020 Innsbruck

    Phone: 0512/507-7151
    Fax: 0512/507-2788
    Web page:

    More information through EDIRC

    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.:

    in new window

    1. Pita Barros, Pedro & Siciliani, Luigi, 2011. "Public and Private Sector Interface," Handbook of Health Economics, Elsevier.
    2. Maria Goddard & Peter Smith, 1998. "Equity of access to health care," Working Papers 032cheop, Centre for Health Economics, University of York.
    3. Jacobson, Lena, 2000. "The family as producer of health -- an extended grossman model," Journal of Health Economics, Elsevier, vol. 19(5), pages 611-637, September.
    4. Manos Matsaganis & Theodore Mitrakos & Panos Tsakloglou, 2009. "Modelling health expenditure at the household level in Greece," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 10(3), pages 329-336, July.
    5. Joan Costa-Font & Panos Kanavos & Joan Rovira, 2007. "Determinants of out-of-pocket pharmaceutical expenditure and access to drugs in Catalonia," Applied Economics, Taylor & Francis Journals, vol. 39(5), pages 541-551.
    6. Thomas F. Crossley & Joachim K. Winter, 2014. "Asking Households about Expenditures: What Have We Learned?," NBER Chapters,in: Improving the Measurement of Consumer Expenditures, pages 23-50 National Bureau of Economic Research, Inc.
    7. Marcel Bilger & Jean-Paul Chaze, 2008. "What Drives Individual Health Expenditure in Switzerland?," Swiss Journal of Economics and Statistics (SJES), Swiss Society of Economics and Statistics (SSES), vol. 144(III), pages 337-358, September.
    8. Jean-Paul Chaze, 2005. "Assessing household health expenditure with Box-Cox censoring models," Health Economics, John Wiley & Sons, Ltd., vol. 14(9), pages 893-907.
    9. Madden, David, 2008. "Sample selection versus two-part models revisited: The case of female smoking and drinking," Journal of Health Economics, Elsevier, vol. 27(2), pages 300-307, March.
    10. Shuyun May Li, Solmaz Moslehi, Siew Ling Yew, 2012. "Public-Private Mix of Health Expenditure: A Political Economy Approach and A Quantitative Exercise," Department of Economics - Working Papers Series 1157, The University of Melbourne.
    11. Glenn Jones & Elizabeth Savage & Kees Van Gool, 2008. "The Distribution of Household Health Expenditures in Australia," The Economic Record, The Economic Society of Australia, vol. 84(s1), pages 99-114, September.
    12. Propper, Carol, 2000. "The demand for private health care in the UK," Journal of Health Economics, Elsevier, vol. 19(6), pages 855-876, November.
    13. Kasje, W. N. & Timmer, J. W. & Boendermaker, P. M. & Haaijer-Ruskamp, F. M., 2002. "Dutch GPs' perceptions: the influence of out-of-pocket costs on prescribing," Social Science & Medicine, Elsevier, vol. 55(9), pages 1571-1578, November.
    14. Jowett, M. & Contoyannis, P. & Vinh, N. D., 2003. "The impact of public voluntary health insurance on private health expenditures in Vietnam," Social Science & Medicine, Elsevier, vol. 56(2), pages 333-342, January.
    15. Miguel Gouveia, 1997. "Majority rule and the public provision of a private good," Public Choice, Springer, vol. 93(3), pages 221-244, December.
    16. Borislava Mihaylova & Andrew Briggs & Anthony O'Hagan & Simon G. Thompson, 2011. "Review of statistical methods for analysing healthcare resources and costs," Health Economics, John Wiley & Sons, Ltd., vol. 20(8), pages 897-916, August.
    17. Naeem Ahmed & Matthew Brzozowski & Thomas Crossley, 2006. "Measurement errors in recall food consumption data," IFS Working Papers W06/21, Institute for Fiscal Studies.
    Full references (including those not matched with items on IDEAS)

    This item is not listed on Wikipedia, on a reading list or among the top items on IDEAS.

    When requesting a correction, please mention this item's handle: RePEc:inn:wpaper:2014-04. 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: (Janette Walde)

    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.

    This information is provided to you by IDEAS at the Research Division of the Federal Reserve Bank of St. Louis using RePEc data.