Use of hospital services and socio-economic status in urban India: Does health insurance ensure equitable outcomes?
In recent years universal health coverage has become an important issue in developing countries. Successful introduction of such a social security system requires knowledge of the relationship between socio-economic status and usage of health care services. This paper examines this relationship, and analyzes the impact of introducing health insurance into the model, using data for India, a major developing country with poor health outcomes. In contrast to similar works undertaken for developed countries, results of the instrumental variable model estimated reveals that the positive relation between usage of in-patient services and socio-economic status persists even in the presence of health insurance. This implies that insurance is unable to eliminate the inequities in accessing health care services stemming from disparities in socio-economic status. In fact, the presence of a double moral hazard and adverse selection leads to further attenuation of inequity in the health care market. The study is based on unit level data from the “Morbidity and Health Care Survey” undertaken by the National Sample Survey Organization (2005-06).
|Date of creation:||12 Jul 2012|
|Date of revision:|
|Contact details of provider:|| Postal: Ludwigstraße 33, D-80539 Munich, Germany|
Web page: https://mpra.ub.uni-muenchen.de
More information through EDIRC
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.:
- Sugato Bhattacharyya & Francine Lafontaine, 1995. "Double-Sided Moral Hazard and the Nature of Share Contracts," RAND Journal of Economics, The RAND Corporation, vol. 26(4), pages 761-781, Winter.
- Selden, Thomas M., 1990. "A model of capitation," Journal of Health Economics, Elsevier, vol. 9(4), pages 397-409, December.
- Reinhardt, Uwe E., 1985. "The theory of physician-induced demand reflections after a decade," Journal of Health Economics, Elsevier, vol. 4(2), pages 187-193, June.
- Ellis, Randall P. & McGuire, Thomas G., 1990. "Optimal payment systems for health services," Journal of Health Economics, Elsevier, vol. 9(4), pages 375-396, December.
- Grossman, Michael, 1972. "On the Concept of Health Capital and the Demand for Health," Journal of Political Economy, University of Chicago Press, vol. 80(2), pages 223-55, March-Apr.
- Wagstaff, Adam, 1986. "The demand for health : Some new empirical evidence," Journal of Health Economics, Elsevier, vol. 5(3), pages 195-233, September.
- Culyer, A. J. & Wagstaff, Adam, 1993. "Equity and equality in health and health care," Journal of Health Economics, Elsevier, vol. 12(4), pages 431-457, December.
- Martin Gaynor, 1994.
"Issues in the Industrial Organization of the Market for Physician Services,"
NBER Working Papers
4695, National Bureau of Economic Research, Inc.
- Gaynor, Martin, 1994. "Issues in the Industrial Organization of the Market for Physician Services," Journal of Economics & Management Strategy, Wiley Blackwell, vol. 3(1), pages 211-55, Spring.
- Kim, Son Ku & Wang, Susheng, 1998. "Linear Contracts and the Double Moral-Hazard," Journal of Economic Theory, Elsevier, vol. 82(2), pages 342-378, October.
- Adam Wagstaff & Eddy van Doorslaer, 2003. "Catastrophe and impoverishment in paying for health care: with applications to Vietnam 1993-1998," Health Economics, John Wiley & Sons, Ltd., vol. 12(11), pages 921-933.
- Franque Grimard & Daniel Parent, 2003.
"Education and Smoking: Were Vietnam War Draft Avoiders Also More Likely to Avoid Smoking?,"
Cahiers de recherche
- Grimard, Franque & Parent, Daniel, 2007. "Education and smoking: Were Vietnam war draft avoiders also more likely to avoid smoking?," Journal of Health Economics, Elsevier, vol. 26(5), pages 896-926, September.
- Franque Grimard & Daniel Parent, 2003. "Education and Smoking: Were Vietnam War Draft Avoiders Also More Likely to Avoid Smoking?," CIRANO Working Papers 2003s-44, CIRANO.
- Franque Grimard & Daniel Parent, 2006. "Education And Smoking: Were Vietnam War Draft Avoiders Also More Likely To Avoid Smoking?," Departmental Working Papers 2006-05, McGill University, Department of Economics.
- Ma, Ching-to Albert & McGuire, Thomas G, 1997.
"Optimal Health Insurance and Provider Payment,"
American Economic Review,
American Economic Association, vol. 87(4), pages 685-704, September.
- Matthew Jowett & Anil Deolalikar & Peter Martinsson, 2004. "Health insurance and treatment seeking behaviour: evidence from a low-income country," Health Economics, John Wiley & Sons, Ltd., vol. 13(9), pages 845-857.
- Wolfe, Barbara L. & Behrman, Jere R., 1982. "Determinants of child mortality, health, and nutrition in a developing country," Journal of Development Economics, Elsevier, vol. 11(2), pages 163-193, October.
- Joel S. Demski & David E.M. Sappington, 1991. "Resolving Double Moral Hazard Problems with Buyout Agreements," RAND Journal of Economics, The RAND Corporation, vol. 22(2), pages 232-240, Summer.
- van den Berg, Agnes E. & Maas, Jolanda & Verheij, Robert A. & Groenewegen, Peter P., 2010. "Green space as a buffer between stressful life events and health," Social Science & Medicine, Elsevier, vol. 70(8), pages 1203-1210, April.
- Feldstein, Martin S, 1977. "Quality Change and the Demand for Hospital Care," Econometrica, Econometric Society, vol. 45(7), pages 1681-1702, October.
- Philip Oreopoulos, 2006. "Estimating Average and Local Average Treatment Effects of Education when Compulsory Schooling Laws Really Matter," American Economic Review, American Economic Association, vol. 96(1), pages 152-175, March.
- Kakwani, Nanak & Wagstaff, Adam & van Doorslaer, Eddy, 1997. "Socioeconomic inequalities in health: Measurement, computation, and statistical inference," Journal of Econometrics, Elsevier, vol. 77(1), pages 87-103, March.
- Hurley, Jeremiah, 2000. "An overview of the normative economics of the health sector," Handbook of Health Economics, in: A. J. Culyer & J. P. Newhouse (ed.), Handbook of Health Economics, edition 1, volume 1, chapter 2, pages 55-118 Elsevier.
- Russell Cooper & T.W. Ross, 1984.
"Product Warranties and Double Moral Hazard,"
Cowles Foundation Discussion Papers
716, Cowles Foundation for Research in Economics, Yale University.
- Aradhna Aggarwal, 2010. "Impact evaluation of India's ‘Yeshasvini’ community‐based health insurance programme," Health Economics, John Wiley & Sons, Ltd., vol. 19(S1), pages 5-35, September.
- Blomqvist, Ake, 1991. "The doctor as double agent: Information asymmetry, health insurance, and medical care," Journal of Health Economics, Elsevier, vol. 10(4), pages 411-432.
When requesting a correction, please mention this item's handle: RePEc:pra:mprapa:40055. 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: (Joachim Winter)
If references are entirely missing, you can add them using this form.