What drives out-of pocket health expenditures of private households? - Empirical evidence from the Austrian household budget survey
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.
|Date of creation:||Feb 2014|
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- 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, 08.
- 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.
- Thomas F. Crossley & Joachim K. Winter, 2013.
"Asking Households About Expenditures: What Have We Learned?,"
NBER Working Papers
19543, National Bureau of Economic Research, Inc.
- 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.
- Shuyun May Li & Solmaz Moslehi & Siew Ling Yew, 2012.
"Public-Private Mix of Health Expenditure: A Political Economy Approach and A Quantitative Exercise,"
Monash Economics Working Papers
11-12, Monash University, Department of Economics.
- 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.
- 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.
- 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.
- David Madden, 2006. "Sample Selection Versus Two-Part Models Revisited: the Case of Female Smoking and Drinking," Health, Econometrics and Data Group (HEDG) Working Papers 06/12, HEDG, c/o Department of Economics, University of York.
- Madden, David, 2006. "Sample Selection Versus Two-Part Models Revisited: The Case of Female Smoking and Drinking," Papers HRBWP23, Economic and Social Research Institute (ESRI).
- David (David Patrick) Madden, 2006. "Sample selection versus two-part models revisited : the case of female smoking and drinking," Working Papers 200604, School of Economics, University College Dublin.
- 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.
- 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 S99-S114, 09.
- Maria Goddard & Peter Smith, 1998. "Equity of access to health care," Working Papers 032cheop, Centre for Health Economics, University of York.
- 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.
- Naeem Ahmed & Matthew Brzozowski & Thomas Crossley, 2006. "Measurement errors in recall food consumption data," IFS Working Papers W06/21, Institute for Fiscal Studies.
- Gouveia, Miguel, 1997.
"Majority Rule and the Public Provision of a Private Good,"
Springer, vol. 93(3-4), pages 221-44, December.
- Miguel Gouveia, 1997. "Majority rule and the public provision of a private good," Public Choice, Springer, vol. 93(3), pages 221-244, December.
- 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.
- 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.
- Propper, Carol, 2000. "The demand for private health care in the UK," Journal of Health Economics, Elsevier, vol. 19(6), pages 855-876, November.
- 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.
- Pita Barros, Pedro & Siciliani, Luigi, 2011. "Public and Private Sector Interface," Handbook of Health Economics, Elsevier.
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