- Open Access
The Determinants of Health Care Utilization in Portugal: An Approach with Count Data Models
Swiss Journal of Economics and Statistics volume 144, pages 437–458 (2008)
This work aims to identify the determinants of health care utilization in Portugal and to quantify their effects. A clear idea about this may help the policy debate on the delivery and organization of health services. Toward this end, we developed an approach based on count data models. We found that demographic factors influence health care demand; unemployment strongly increases utilization, and income effects are only observed for frequent users. Furthermore, chronic conditions increase demand for health services, and personal habits have mixed effects. Both private insurance and the use of subsystems increase the utilization.
Bago d’Uva, T. (2005), “Latent Class Models for Utilization of Health Care”, Health Economics, 14, pp. 873–892.
Barros, P. P. (2005), “Economia da Saude: Conceitos e Comportamentos”, Almedina.
Cameron, A. C., P. K. Trivedi, F. Milne, and J. Piggot (1988), “A Micro-econometric Model of the Demand for Health Care and Health Insurance in Australia”, Review of Economic Studies, 55, pp. 85–106.
Cameron, A. C., and P. K. Trivedi (1998), Regression Analysis of Count Data, Econometric Society Monographs, vol. 30. New York, Cambridge University Press.
Cameron, A. C., and P. K. Trivedi (2005), Microeconometrics: Methods and Applications, Cambridge University Press.
Deb, P., and P. K. Triverdi (1997), “Demand for Medical Care by the Elderly: A Finite Mixture Approach”, Journal of Applied Econometrics, 12, pp. 313–336.
Deb, P., and P. K. Triverdi (2002), “The Structure of Demand for Health Care: Latent Class versus Two-Part Models”, Journal of Health Economics, 21, pp. 601–625.
Dempster, A., N. Laird and D. Rubin (1977), “Maximum Likelihood from Incomplete Data via the EM Algorithm”, Journal of the Royal Statistical Society. Series B (Methodological), 39, pp. 1–38.
Gerdtham, U. G. (1997), “Equity in Health Care Utilization: Further Tests Based on Hurdle Model and Swedish Micro Data”, Health Economics, 6.
Gourieroux, C., A. Monfort and A. Trognon (1984), “Pseudo Maximum Likelihood Methods: Theory”, Econometrica, 52, pp. 681–700.
Grogger, J. T., and R. T. Carson (1991), “Models for Truncated Counts”, Journal of Applied Econometrics, 6, pp. 225–238.
Grossman, M. (1972), “On the Concept of Health Capital and the Demand for Health”, Journal of Political Economics, 80, pp. 223–235.
Hausman, J., B. H. Hall and Z. Griliches (1984), “Econometric Models for Count Data with an Application to the Patents-R&D Relationship”, Econometrica, 52, pp. 909–938.
Lourenço, O. D., and P. L. Ferreira (2005), “Utilization of Public Health Centers in Portugal: Effect of Time Costs and Other Determinants. Finite Mixture Models applied to Truncated Samples”, Health Economics, 14, pp. 939–953.
Pohlmeier, W., and V. Ulrich (1995), “An Econometric Model of the Two-Part Decision Making Process in the Demand for Health Care”, Journal of Human Resources, 30, pp. 339–361.
Sarma, S., and W. Simpson (2006), “A Microeconometric Analysis of Canadian Health Care Utilization”, Health Economics, 15, pp. 219–239.
Sindelar, J. L. (1982), “Differential Use of Medical Care by Sex”, The Journal of Political Economy, 90, pp. 1003–1019.
Verbeek, M. (2004), A Guide to Modern Econometrics, 2nd Edition, John Wiley & Sons, Ltd.
Wedel, M., W. S. Desarbo, J. R. Bult and V. Ramaswamy (1993), “A Latent Class Poisson Regression Model for Heterogeneous Count Data”, Journal of Applied Econometrics, 8, pp. 397–411.
Wedel, M., and W. A. Kamakura (1999), Market Segmentation: Conceptual and Methodological Foundations, Dordrecht, Kluwer, 2nd edition.
Windmeijer, F. A., and J. M. C. Santos Silva (1997), “Endogeneity in Count Data Models: An Application to Demand for Health Care”, Journal of Applied Econometrics, 12, pp. 281–294.
I am very grateful to Pedro Portugal who helped me throughout this paper as my master advisor. Additionally, I would like to thank to Pedro Pita Barros, Mafalda Sampaio, Miguel Câmara and Pedro Robalo for their important suggestions and corrections.
About this article
Cite this article
Salvado, J.C. The Determinants of Health Care Utilization in Portugal: An Approach with Count Data Models. Swiss J Economics Statistics 144, 437–458 (2008). https://doi.org/10.1007/BF03399261
- health care utilization
- count data models