SUMMARYIn the absence of formal health insurance, we argue that the strategies households adopt to finance health care have important implications for the measurement and interpretation of how health payments impact on consumption and poverty. Given data on source of finance, we propose to (a) approximate the relative impact of health payments on current consumption with a 'coping'-adjusted health expenditure ratio, (b) uncover poverty that is 'hidden' because total household expenditure is inflated by financial coping strategies and (c) identify poverty that is 'transient' because necessary consumption is temporarily sacrificed to pay for health care. Measures that ignore coping strategies not only overstate the risk to current consumption and exaggerate the scale of catastrophic payments but also overlook the long-run burden of health payments. Nationally representative data from India reveal that coping strategies finance as much as three-quarters of the cost of inpatient care. Payments for inpatient care exceed 10% of total household expenditure for around 30% of hospitalized households but less than 4% sacrifice more than 10% of current consumption to accommodate this spending.Ignoring health payments leads to underestimate poverty by 7-8% points among hospitalized households; 80% of this adjustment is hidden poverty due to coping.
Summary. -This paper proposes a suitable theoretical framework for operationalizing the capability approach using the latent variable methodology. A structural equation model is specified to account for the unobservable and multidimensional aspects characterizing the concept of human development and to capture the mutual influence among different capabilities. The model is applied to Bolivian data for studying two ''basic'' capability domains relating to children: knowledge and living conditions. Individual capability indices are constructed from the estimation results and their empirical distributions analyzed. Our results show a strong interdependence between the above capabilities and confirm the role of exogenous factors in their determination.
Recent empirical literature has seen many multidimensional indices emerge as well-being or poverty measures, in particular indices derived from principal components and various latent variable models. Though such indices are being increasingly and widely employed, few studies motivate their use or report the standard errors or confidence intervals associated with these estimators. This paper reviews the different underlying models, reaffirms their appropriateness in this context, examines the statistical properties of resulting indices, gives analytical expressions of their variances and establishes certain exact relationships among them.
Any attempt to operationalize the capability approach necessitates an adequate framework for the measurement of the abstract unobservable multidimensional concept that the term 'capability' stands for. One such attempt is the latent variable approach, which considers the different dimensions of capability or human development as unobserved variables (factors) manifesting themselves through measurable indicators. In this paper, we propose a structural equation econometric model that accounts for the interdependence among the latent dimensions and other observed endogenous factors and includes causal exogenous variables affecting the latent dimensions and their indicators. We estimate the model using data on a cross-section of countries across the world and use our empirical model to derive capability indicators in different dimensions.Human development, Capability approach, Latent variables, Item response, Simultaneous equations,
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