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From the same journal

Addressing care-seeking as well as insurance-seeking selection biases in estimating the impact of health insurance on out-of-pocket expenditure

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Addressing care-seeking as well as insurance-seeking selection biases in estimating the impact of health insurance on out-of-pocket expenditure. / Ali, Shehzad; Cookson, Richard Andrew; Dusheiko, Mark Alan.

In: Social science and medicine, Vol. 177, 03.2017, p. 127-140.

Research output: Contribution to journalArticle

Harvard

Ali, S, Cookson, RA & Dusheiko, MA 2017, 'Addressing care-seeking as well as insurance-seeking selection biases in estimating the impact of health insurance on out-of-pocket expenditure', Social science and medicine, vol. 177, pp. 127-140. https://doi.org/10.1016/j.socscimed.2016.11.005

APA

Ali, S., Cookson, R. A., & Dusheiko, M. A. (2017). Addressing care-seeking as well as insurance-seeking selection biases in estimating the impact of health insurance on out-of-pocket expenditure. Social science and medicine, 177, 127-140. https://doi.org/10.1016/j.socscimed.2016.11.005

Vancouver

Ali S, Cookson RA, Dusheiko MA. Addressing care-seeking as well as insurance-seeking selection biases in estimating the impact of health insurance on out-of-pocket expenditure. Social science and medicine. 2017 Mar;177:127-140. https://doi.org/10.1016/j.socscimed.2016.11.005

Author

Ali, Shehzad ; Cookson, Richard Andrew ; Dusheiko, Mark Alan. / Addressing care-seeking as well as insurance-seeking selection biases in estimating the impact of health insurance on out-of-pocket expenditure. In: Social science and medicine. 2017 ; Vol. 177. pp. 127-140.

Bibtex - Download

@article{589395a5a7604b24aa1309d8b2bbd8c4,
title = "Addressing care-seeking as well as insurance-seeking selection biases in estimating the impact of health insurance on out-of-pocket expenditure",
abstract = "Health Insurance (HI) programmes in low-income countries aim to reduce the burden of individual out-of-pocket (OOP) health care expenditure. However, if the decisions to purchase insurance and to seek care when ill are correlated with the expected healthcare expenditure, the use of na{\"i}ve models may produce biased estimates of the impact of insurance membership on OOP expenditure. Whilst many studies in the literature have accounted for the endogeneity of the insurance decision, the potential selection bias due to the care-seeking decision has not been taken into account. We extend the Heckman selection model to account simultaneously for both care-seeking and insurance-seeking selection biases in the healthcare expenditure regression model. The proposed model is illustrated in the context of a Vietnamese HI programme using data from a household survey of 1192 individuals conducted in 1999. Results were compared with those of alternative econometric models making no or partial allowance for selection bias. In this illustrative example, the impact of insurance membership on reducing OOP expenditures was underestimated by 21 percentage points when selection biases were not taken into account. We believe this is an important methodological contribution that will be relevant to future empirical work.",
author = "Shehzad Ali and Cookson, {Richard Andrew} and Dusheiko, {Mark Alan}",
note = "{\textcopyright} 2016 Elsevier Ltd. This is an author-produced version of the published paper. Uploaded in accordance with the publisher{\textquoteright}s self-archiving policy",
year = "2017",
month = mar,
doi = "10.1016/j.socscimed.2016.11.005",
language = "English",
volume = "177",
pages = "127--140",
journal = "Social Science & Medicine",
issn = "0277-9536",
publisher = "Elsevier Limited",

}

RIS (suitable for import to EndNote) - Download

TY - JOUR

T1 - Addressing care-seeking as well as insurance-seeking selection biases in estimating the impact of health insurance on out-of-pocket expenditure

AU - Ali, Shehzad

AU - Cookson, Richard Andrew

AU - Dusheiko, Mark Alan

N1 - © 2016 Elsevier Ltd. This is an author-produced version of the published paper. Uploaded in accordance with the publisher’s self-archiving policy

PY - 2017/3

Y1 - 2017/3

N2 - Health Insurance (HI) programmes in low-income countries aim to reduce the burden of individual out-of-pocket (OOP) health care expenditure. However, if the decisions to purchase insurance and to seek care when ill are correlated with the expected healthcare expenditure, the use of naïve models may produce biased estimates of the impact of insurance membership on OOP expenditure. Whilst many studies in the literature have accounted for the endogeneity of the insurance decision, the potential selection bias due to the care-seeking decision has not been taken into account. We extend the Heckman selection model to account simultaneously for both care-seeking and insurance-seeking selection biases in the healthcare expenditure regression model. The proposed model is illustrated in the context of a Vietnamese HI programme using data from a household survey of 1192 individuals conducted in 1999. Results were compared with those of alternative econometric models making no or partial allowance for selection bias. In this illustrative example, the impact of insurance membership on reducing OOP expenditures was underestimated by 21 percentage points when selection biases were not taken into account. We believe this is an important methodological contribution that will be relevant to future empirical work.

AB - Health Insurance (HI) programmes in low-income countries aim to reduce the burden of individual out-of-pocket (OOP) health care expenditure. However, if the decisions to purchase insurance and to seek care when ill are correlated with the expected healthcare expenditure, the use of naïve models may produce biased estimates of the impact of insurance membership on OOP expenditure. Whilst many studies in the literature have accounted for the endogeneity of the insurance decision, the potential selection bias due to the care-seeking decision has not been taken into account. We extend the Heckman selection model to account simultaneously for both care-seeking and insurance-seeking selection biases in the healthcare expenditure regression model. The proposed model is illustrated in the context of a Vietnamese HI programme using data from a household survey of 1192 individuals conducted in 1999. Results were compared with those of alternative econometric models making no or partial allowance for selection bias. In this illustrative example, the impact of insurance membership on reducing OOP expenditures was underestimated by 21 percentage points when selection biases were not taken into account. We believe this is an important methodological contribution that will be relevant to future empirical work.

U2 - 10.1016/j.socscimed.2016.11.005

DO - 10.1016/j.socscimed.2016.11.005

M3 - Article

VL - 177

SP - 127

EP - 140

JO - Social Science & Medicine

JF - Social Science & Medicine

SN - 0277-9536

ER -