A Comparison of Alternative Methods to Model Endogeneity in Count Models. An Application to the Demand for Health Care and Health Insurance Choice
Several estimators have been suggested to tackle the problem of endogenous regressors and selectivity in count regression models. They differ in the structure and the degree of parametrization of the underlying models. The estimation of health services utilization conditional on the choice of different forms of health insurance provides a classical example of such problems. In Switzerland, basic health insurance is mandatory and each individual is insured separately. The insurance premium varies by region of residence but is independent of income and risk. The insured face a minimal annual deductible for ambulatory health services. Annually, they are given a choice of higher deductibles to reduce their insurance premium by a regulated percentage. The choice of a higher deductible sets incentives for a more cautious utilization of health services. Clearly, the choice is made based on expected health service utilization. The effect of the choice of a higher than the minimal deductible on the number of physician visits is analyzed. A matching estimator, a GMM estimator, two-stage method of moments estimators which account for selectivity and endogenous switching count regression models are applied to data from the 1997 Swiss Health Survey. Incentive-induced behavioral changes are disentangled from selection effects. The main finding is that most of the observed lower utilization for individuals with a high insurance deductible is caused by self- selection of individuals into the respective insurance contracts which either differ in their preferences or are healthier in unobserved aspects of their health status.
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- Gerfin, Michael & Lechner, Michael, 2000.
"Microeconometric Evaluation of the Active Labour Market Policy in Switzerland,"
IZA Discussion Papers
154, Institute for the Study of Labor (IZA).
- Michael Gerfin & Michael Lechner, 2002. "A Microeconometric Evaluation of the Active Labour Market Policy in Switzerland," Economic Journal, Royal Economic Society, vol. 112(482), pages 854-893, October.
- Windmeijer, F A G & Silva, J M C Santos, 1997.
"Endogeneity in Count Data Models: An Application to Demand for Health Care,"
Journal of Applied Econometrics,
John Wiley & Sons, Ltd., vol. 12(3), pages 281-94, May-June.
- Frank Windmeijer & Joao Santos Silva, 1996. "Endogeneity in count data models; an application to demand for health care," IFS Working Papers W96/15, Institute for Fiscal Studies.
- John Mullahy, 1997. "Instrumental-Variable Estimation Of Count Data Models: Applications To Models Of Cigarette Smoking Behavior," The Review of Economics and Statistics, MIT Press, vol. 79(4), pages 586-593, November.
- Alberto HOLLY & Lucien GARDIOL & Gianfranco DOMENIGHETTI & Brigitte BISIG, 1998.
"An Econometric Model of Health Care Utilization and Health Insurance in Switzerland,"
Cahiers de Recherches Economiques du Département d'Econométrie et d'Economie politique (DEEP)
9803, Université de Lausanne, Faculté des HEC, DEEP.
- Holly, Alberto & Gardiol, Lucien & Domenighetti, Gianfranco & Brigitte Bisig, 1998. "An econometric model of health care utilization and health insurance in Switzerland," European Economic Review, Elsevier, vol. 42(3-5), pages 513-522, May.
- James J. Heckman & Hidehiko Ichimura & Petra Todd, 1998. "Matching As An Econometric Evaluation Estimator," Review of Economic Studies, Oxford University Press, vol. 65(2), pages 261-294.
- A. C. Cameron & P. K. Trivedi & Frank Milne & J. Piggott, 1988. "A Microeconometric Model of the Demand for Health Care and Health Insurance in Australia," Review of Economic Studies, Oxford University Press, vol. 55(1), pages 85-106.
- Heckman, James J, 1978.
"Dummy Endogenous Variables in a Simultaneous Equation System,"
Econometric Society, vol. 46(4), pages 931-59, July.
- James J. Heckman, 1977. "Dummy Endogenous Variables in a Simultaneous Equation System," NBER Working Papers 0177, National Bureau of Economic Research, Inc.
- Mullahy, John, 1986. "Specification and testing of some modified count data models," Journal of Econometrics, Elsevier, vol. 33(3), pages 341-365, December.
- Terza, Joseph V., 1998. "Estimating count data models with endogenous switching: Sample selection and endogenous treatment effects," Journal of Econometrics, Elsevier, vol. 84(1), pages 129-154, May.
- van Ophem, Hans, 2000. "Modeling Selectivity in Count-Data Models," Journal of Business & Economic Statistics, American Statistical Association, vol. 18(4), pages 503-11, October.
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