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Equity in Swedish Health Care Reconsidered: New Results based on the Finite Mixture Model

Author

Listed:
  • Gerdtham, Ulf-G.

    (Dept. of Economics, Stockholm School of Economics)

  • Trivedi, Pravin K.

    (Department of Economics, Indiana University)

Abstract
This paper reconsiders the equity issue in Swedish health care utilisation previously analyzed by Gerdtham (Health Economics 6, 303-319, 1997) within the framework of the standard two-part model. Departing from the user/nonuser distinction, we use the more flexible framework of the finite mixture model that distinguishes between frequent/infrequent users. Our empirical results indicate that the finite mixture model fits the data better than the two-part model. The results indicate that income increases use among infrequent users in both physician and hospital care but that there is no such income effect among frequent users.

Suggested Citation

  • Gerdtham, Ulf-G. & Trivedi, Pravin K., 2000. "Equity in Swedish Health Care Reconsidered: New Results based on the Finite Mixture Model," SSE/EFI Working Paper Series in Economics and Finance 365, Stockholm School of Economics.
    • Handle: RePEc:hhs:hastef:0365
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    1. Ulf‐ G. Gerdtham, 1997. "Equity in Health Care Utilization: Further Tests Based on Hurdle Models and Swedish Micro Data," Health Economics, John Wiley & Sons, Ltd., vol. 6(3), pages 303-319, May.
    2. 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.
    3. Mullahy, John, 1986. "Specification and testing of some modified count data models," Journal of Econometrics, Elsevier, vol. 33(3), pages 341-365, December.
    4. Wagstaff, Adam & van Doorslaer, Eddy, 2000. "Chapter 34 Equity in health care finance and delivery," Handbook of Health Economics, in: A. J. Culyer & J. P. Newhouse (ed.), Handbook of Health Economics, edition 1, volume 1, chapter 34, pages 1803-1862, Elsevier.
    5. Deb, Partha & Trivedi, Pravin K, 1997. "Demand for Medical Care by the Elderly: A Finite Mixture Approach," Journal of Applied Econometrics, John Wiley & Sons, Ltd., vol. 12(3), pages 313-336, May-June.
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    Cited by:

    1. Erik Schokkaert & Tom Van Ourti & Diana De Graeve & Ann Lecluyse & Carine Van de Voorde, 2010. "Supplemental health insurance and equality of access in Belgium," Health Economics, John Wiley & Sons, Ltd., vol. 19(4), pages 377-395, April.
    2. 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.
    3. Óscar D. Lourenço & Pedro L. Ferreira, 2005. "Utilization of public health centres in Portugal: effect of time costs and other determinants. Finite mixture models applied to truncated samples," Health Economics, John Wiley & Sons, Ltd., vol. 14(9), pages 939-953, September.
    4. Teresa Bago d'Uva, 2005. "Latent class models for use of primary care: evidence from a British panel," Health Economics, John Wiley & Sons, Ltd., vol. 14(9), pages 873-892, September.
    5. Anders Anell, 2005. "Swedish healthcare under pressure," Health Economics, John Wiley & Sons, Ltd., vol. 14(S1), pages 237-254, September.
    6. Bago d'Uva, Teresa & Jones, Andrew M. & van Doorslaer, Eddy, 2009. "Measurement of horizontal inequity in health care utilisation using European panel data," Journal of Health Economics, Elsevier, vol. 28(2), pages 280-289, March.
    7. Hendrik Schmitz, 2012. "More health care utilization with more insurance coverage? Evidence from a latent class model with German data," Applied Economics, Taylor & Francis Journals, vol. 44(34), pages 4455-4468, December.
    8. 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.
    9. José-Ignacio Antón & Rafael Muñoz de Bustillo, 2010. "Health care utilisation and immigration in Spain," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 11(5), pages 487-498, October.
    10. 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).
    11. Michael Creel & Montserrat Farell, 2005. "Modeling Usage of Medical Care Services: The Medical Expenditure Panel Survey Data, 1996-2000," UFAE and IAE Working Papers 646.05, Unitat de Fonaments de l'Anàlisi Econòmica (UAB) and Institut d'Anàlisi Econòmica (CSIC).
    12. Lu Wencong & Cheng Ying & Mohummed Shofi Ullah Mazumder, 2014. "Competent Alternative Model for the Peasants' Medical Expenditures in China: A Case of New Rural Cooperative Medical Service System (Nrcms) in Zhejiang Province," Prague Economic Papers, Prague University of Economics and Business, vol. 2014(2), pages 233-249.
    13. Zhou, Yang & Shi, Zhixiong & Shi, Zhengyu & Gao, Qing & Wu, Libo, 2019. "Disaggregating power consumption of commercial buildings based on the finite mixture model," Applied Energy, Elsevier, vol. 243(C), pages 35-46.
    14. Bago d'Uva, Teresa & Jones, Andrew M., 2009. "Health care utilisation in Europe: New evidence from the ECHP," Journal of Health Economics, Elsevier, vol. 28(2), pages 265-279, March.
    15. 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.
    16. Nordin, Martin & Dackehag, Margareta & Gerdtham, Ulf-G., 2013. "Socioeconomic inequalities in drug utilization for Sweden: Evidence from linked survey and register data," Social Science & Medicine, Elsevier, vol. 77(C), pages 106-117.
    17. Nordin , Martin & Gerdtham , Ulf-G, 2010. "Why a positive link between age and income-related health inequality?," Working Papers 2010:12, Lund University, Department of Economics.
    18. Michael D. Creel & Montserrat Farell, 2001. "Likelihood-Based Approaches to Modeling Demand for Medical Care," UFAE and IAE Working Papers 498.01, Unitat de Fonaments de l'Anàlisi Econòmica (UAB) and Institut d'Anàlisi Econòmica (CSIC).
    19. Mohammad Hajizadeh & Luke B. Connelly & James R.G. Butler & Aredshir Khosravi, 2012. "Unmet need and met unneed in health care utilisation in Iran," International Journal of Social Economics, Emerald Group Publishing Limited, vol. 39(6), pages 400-422, May.
    20. David Madden & Anne Nolan & Brian Nolan, 2005. "GP reimbursement and visiting behaviour in Ireland," Health Economics, John Wiley & Sons, Ltd., vol. 14(10), pages 1047-1060, October.
    21. Nabanita Datta Gupta & Jane Greve, 2011. "Overweight and obesity and the utilization of primary care physicians," Health Economics, John Wiley & Sons, Ltd., vol. 20(S1), pages 53-67, September.
    22. 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.
    23. Sunday Azagba & Mesbah Sharaf & Christina Xiao Liu, 2013. "Disparities in health care utilization by smoking status in Canada," International Journal of Public Health, Springer;Swiss School of Public Health (SSPH+), vol. 58(6), pages 913-925, December.

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    More about this item

    Keywords

    Equity; health care; count data; latent class models; finite mixture models;
    All these keywords.

    JEL classification:

    • C20 - Mathematical and Quantitative Methods - - Single Equation Models; Single Variables - - - General
    • C25 - Mathematical and Quantitative Methods - - Single Equation Models; Single Variables - - - Discrete Regression and Qualitative Choice Models; Discrete Regressors; Proportions; Probabilities
    • C52 - Mathematical and Quantitative Methods - - Econometric Modeling - - - Model Evaluation, Validation, and Selection
    • I10 - Health, Education, and Welfare - - Health - - - General
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health

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