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How Did the German Health Care Reform of 1997 Change the Distribution of the Demand for Health Services?

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  • Rainer Winkelmann

    (Socioeconomic Institute, University of Zurich)

Abstract

I consider the problem of evaluating the effect of a health care reform on the demand for doctor visits when the effect is potentially different in different parts of the outcome distribution. Quantile regression is a useful technique for studying such heterogeneous treatment effects. Recent progree has been made to extend such methods to applications with a count dependent variable. An analysis of a 1997 health care reform in Germany shows the benefit of the approach: lower quantiles, such as the 25 percent quantile, fell by substantially larger amounts than what would have been predicted based on Poisson or negative binomial models.

Suggested Citation

  • Rainer Winkelmann, 2003. "How Did the German Health Care Reform of 1997 Change the Distribution of the Demand for Health Services?," SOI - Working Papers 0314, Socioeconomic Institute - University of Zurich.
    • Handle: RePEc:soz:wpaper:0314
    as

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    File URL: https://www.zora.uzh.ch/id/eprint/52186/1/wp0314.pdf
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    References listed on IDEAS

    as
    1. Cameron, A Colin & Trivedi, Pravin K, 1986. "Econometric Models Based on Count Data: Comparisons and Applications of Some Estimators and Tests," Journal of Applied Econometrics, John Wiley & Sons, Ltd., vol. 1(1), pages 29-53, January.
    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. Rainer Winkelmann, 2002. "Health Care Reform and the Number of Doctor Visits � An Econometric Analysis," SOI - Working Papers 0210, Socioeconomic Institute - University of Zurich.
    4. 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.
    5. Rainer Winkelmann, 2004. "Co‐payments for prescription drugs and the demand for doctor visits – Evidence from a natural experiment," Health Economics, John Wiley & Sons, Ltd., vol. 13(11), pages 1081-1089, November.
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    Cited by:

    1. Simon Loertscher & Yves Schneider, 2005. "Switching Costs, Firm Size, and Market Structure," SOI - Working Papers 0508, Socioeconomic Institute - University of Zurich.

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    More about this item

    Keywords

    heterogeneous treatment effect; count data; quantile regression; Poisson 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

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