IDEAS home Printed from https://ideas.repec.org/p/iza/izadps/dp317.html
   My bibliography  Save this paper

Health Care Reform and the Number of Doctor Visits - An Econometric Analysis

Author

Listed:
  • Winkelmann, Rainer

    (University of Zurich)

Abstract

The paper evaluates the German health care reform of 1997, using the individual number of doctor visits as outcome measure. A new econometric model, the Probit-Poisson-log-normal model with correlated errors, describes the data better than existing count data models. Moreover, it has an attractive structural interpretation, as it allows the reforms to have a different effect at different parts of the distribution. The overall effect of the reform was a 10 percent reduction in the number of doctor visits. The effect was much larger in the lower part of the distribution than in the upper part.

Suggested Citation

  • Winkelmann, Rainer, 2001. "Health Care Reform and the Number of Doctor Visits - An Econometric Analysis," IZA Discussion Papers 317, Institute of Labor Economics (IZA).
    • Handle: RePEc:iza:izadps:dp317
    as

    Download full text from publisher

    File URL: https://docs.iza.org/dp317.pdf
    Download Restriction: no
    ---><---

    Other versions of this item:

    References listed on IDEAS

    as
    1. Deb, Partha & Trivedi, Pravin K., 2002. "The structure of demand for health care: latent class versus two-part models," Journal of Health Economics, Elsevier, vol. 21(4), pages 601-625, July.
    2. Mullahy, John, 1986. "Specification and testing of some modified count data models," Journal of Econometrics, Elsevier, vol. 33(3), pages 341-365, December.
    3. Machado, Jose A.F. & Silva, J. M. C. Santos, 2005. "Quantiles for Counts," Journal of the American Statistical Association, American Statistical Association, vol. 100, pages 1226-1237, December.
    4. Santos Silva, Joao M. C. & Windmeijer, Frank, 2001. "Two-part multiple spell models for health care demand," Journal of Econometrics, Elsevier, vol. 104(1), pages 67-89, August.
    5. Vuong, Quang H, 1989. "Likelihood Ratio Tests for Model Selection and Non-nested Hypotheses," Econometrica, Econometric Society, vol. 57(2), pages 307-333, March.
    6. 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 223-255, March-Apr.
    7. Santos Silva, J. M. C., 1997. "Unobservables in count data models for on-site samples," Economics Letters, Elsevier, vol. 54(3), pages 217-220, July.
    Full references (including those not matched with items on IDEAS)

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Rainer Winkelmann, 2002. "Health Care Reform and the Number of Doctor Visits � An Econometric Analysis," SOI - Working Papers 0210, Socioeconomic Institute - University of Zurich.
    2. Sisira Sarma & Wayne Simpson, 2006. "A microeconometric analysis of Canadian health care utilization," Health Economics, John Wiley & Sons, Ltd., vol. 15(3), pages 219-239, March.
    3. BURNEY, Nadeem A. & ALENEZI, Mohammad & HAMADA, Salwa & AL-MUSALLAM, Nadia, 2019. "The Demand for Public and Private Medical Care Services: Evidence from Kuwait," Economia Internazionale / International Economics, Camera di Commercio Industria Artigianato Agricoltura di Genova, vol. 72(1), pages 107-138.
    4. Teresa Bago d'Uva, 2006. "Latent class models for utilisation of health care," Health Economics, John Wiley & Sons, Ltd., vol. 15(4), pages 329-343, April.
    5. Majo, M.C., 2010. "A microeconometric analysis of health care utilization in Europe," Other publications TiSEM 1cf5fd2f-8146-4ef8-8eb5-e, Tilburg University, School of Economics and Management.
    6. Giuliana Luca & Michela Ponzo & Antonio Andrés, 2013. "Health care utilization by immigrants in Italy," International Journal of Health Economics and Management, Springer, vol. 13(1), pages 1-31, March.
    7. Antonio Clavero Barranquero & Mª. Luz González Alvarez, 2005. "A survey of econometric models to analyze the demand and utilisation of health care," Hacienda Pública Española / Review of Public Economics, IEF, vol. 173(2), pages 129-162, June.
    8. Óscar Lourenço & Carlota Quintal & Pedro Lopes Ferreira & Pedro Pita Barros, 2007. "A equidade na utilização de cuidados de saúde em Portugal: Uma avaliação baseada em modelos de contagem," Notas Económicas, Faculty of Economics, University of Coimbra, issue 25, pages 6-26, June.
    9. Alejandra Chovar & Felipe Vásquez & Guillermo Paraje, 2016. "Use of Medical Services in Chile: How Sensitive are The Results to Different Econometric Specifications?," Working Papers Central Bank of Chile 776, Central Bank of Chile.
    10. Moreira S & Pita Barros P, 2009. "Double coverage and demand for health care: Evidence from quantile regression," Health, Econometrics and Data Group (HEDG) Working Papers 09/21, HEDG, c/o Department of Economics, University of York.
    11. Sergi Jiménez‐Martín & José M. Labeaga & Maite Martínez‐Granado, 2002. "Latent class versus two‐part models in the demand for physician services across the European Union," Health Economics, John Wiley & Sons, Ltd., vol. 11(4), pages 301-321, June.
    12. Monika Sander, 2008. "Is There Migration-Related Inequity in Access to or in the Utilisation of Health Care in Germany?," SOEPpapers on Multidisciplinary Panel Data Research 147, DIW Berlin, The German Socio-Economic Panel (SOEP).
    13. Sergi Jiménez-Martín & José Labeaga & Maite Martínez-Granado, 2004. "An empirical analysis of the demand for physician services across the European Union," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 5(2), pages 150-165, May.
    14. Sara Moreira & Pedro Pita Barros, 2010. "Double health insurance coverage and health care utilisation: evidence from quantile regression," Health Economics, John Wiley & Sons, Ltd., vol. 19(9), pages 1075-1092, September.
    15. Marc Saez & Carme Saurina & Germà Coenders & Sònia González‐Raya, 2006. "Use of primary health care services according to the different degrees of obesity in the Girona Health Region, Spain," Health Economics, John Wiley & Sons, Ltd., vol. 15(2), pages 173-193, February.
    16. Winkelmann, Rainer, 2006. "Reforming health care: Evidence from quantile regressions for counts," Journal of Health Economics, Elsevier, vol. 25(1), pages 131-145, January.
    17. Addisu Jember Zeleke & Serena Moscato & Rossella Miglio & Lorenzo Chiari, 2022. "Length of Stay Analysis of COVID-19 Hospitalizations Using a Count Regression Model and Quantile Regression: A Study in Bologna, Italy," IJERPH, MDPI, vol. 19(4), pages 1-18, February.
    18. Galina Besstremyannaya, 2014. "Heterogeneous effect of coinsurance rate on healthcare costs: generalized finite mixtures and matching estimators," Discussion Papers 14-014, Stanford Institute for Economic Policy Research.
    19. McLeod, Logan, 2011. "A nonparametric vs. latent class model of general practitioner utilization: Evidence from Canada," Journal of Health Economics, Elsevier, vol. 30(6), pages 1261-1279.
    20. Daniele Fabbri & Chiara Monfardini, 2003. "Public vs. Private Health Care Services Demand in Italy," Giornale degli Economisti, GDE (Giornale degli Economisti e Annali di Economia), Bocconi University, vol. 62(1), pages 93-123, April.

    More about this item

    Keywords

    count data; moral hazard; Co-payment; probit-Poisson-log-normal model;
    All these keywords.

    JEL classification:

    • I11 - Health, Education, and Welfare - - Health - - - Analysis of Health Care Markets
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health
    • C25 - Mathematical and Quantitative Methods - - Single Equation Models; Single Variables - - - Discrete Regression and Qualitative Choice Models; Discrete Regressors; Proportions; Probabilities

    NEP fields

    This paper has been announced in the following NEP Reports:

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:iza:izadps:dp317. See general information about how to correct material in RePEc.

    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 CitEc recognized a bibliographic reference but did not link an item in RePEc 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 RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Holger Hinte (email available below). General contact details of provider: https://edirc.repec.org/data/izaaade.html .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.