Demand for Medical Care by the Elderly: A Finite Mixture Approach

Deb, Partha; Trivedi, Pravin K.

doi:10.1002/(sici)1099-1255(199705)12:3<313::aid-jae440>3.0.co;2-g

Cited by 417 publications

(347 citation statements)

References 27 publications

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“…Moreover, the estimate of p is large relative to its estimated standard error, and as argued by Cameron and Trivedi [36,42], this evidence supports the FMM with two latent classes. Here we only report the results from FMM with two classes and negative binomial II as component distribution.…”

Section: Resultssupporting

confidence: 78%

“…Models with c ¼ 1 and 2 are nested, so it is possible to use LR tests to choose among them [36,42]. Models with c ¼ 1 were rejected, remaining the comparison of c ¼ 2 and 3.…”

Section: Resultsmentioning

confidence: 99%

“…If the random variable u i is assumed to be continuous, then a continuous mixture model is specified, conversely, when u i is assumed to be discrete then a semi-parametric finite mixture model (FMM) is specified [35,41]. The finite mixture approach has been used by Deb and Trivedi [35,42] [41] show that estimates of a finite mixture might provide good numerical approximations even when the distribution of u i is continuous; second, provides a natural and intuitively attractive representation of unobserved heterogeneity in a finite, usually small, number of latent classes, each of which may be regarded as a 'type' or 'group [35]'. Moreover, empirical investigation has shown that FMM provide good results [35,36,42,43].…”

Section: Econometric Speci¢cationmentioning

confidence: 99%

“…The finite mixture approach has been used by Deb and Trivedi [35,42] [41] show that estimates of a finite mixture might provide good numerical approximations even when the distribution of u i is continuous; second, provides a natural and intuitively attractive representation of unobserved heterogeneity in a finite, usually small, number of latent classes, each of which may be regarded as a 'type' or 'group [35]'. Moreover, empirical investigation has shown that FMM provide good results [35,36,42,43]. Additionally, the potential for identification of latent classes of individuals, based on non-observable characteristics, may be important for interpreting reasons because the impact of some variable may differ across latent classes, and, with little algebra, the impact of this same variable on the population is equally possible to discern.…”

Section: Econometric Speci¢cationmentioning

confidence: 99%

“…In this paper, we estimated models with c ¼ 2 and 3. Regarding the distribution of the component densities we chose the most usual densities applied to model count data, that is, Poisson, negative binomial I and II [35,36,42,43]. We estimate several FMMs which were compared by using Bayesian information criteria (BIC) and consistent Akaike information criteria (CAIC) measures [47].…”

Section: Econometric Speci¢cationmentioning

confidence: 99%

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Utilization of public health centres in Portugal: effect of time costs and other determinants. Finite mixture models applied to truncated samples

Lourenço¹,

Ferreira²

2005

Health Economics

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SummaryThe impact of time costs on the utilization of medical care has been a subject of theoretical and empirical research since the early 1970s.The main goal of this paper is to show the effect of time costs on the number of visits to general practitioners (GP) in Portuguese public health centres. We measured the elasticity of primary health care utilization relative to the total time spent in the health centre and relative to travel time. We also provided evidence regarding the impact of an appointment delay on the utilization of public GP services.Our data resulted from the application of an endogenous sampling scheme, resulting in a truncated-at-zero data set. To model our dependent variable, number of visits, and accounting for the truncated nature of the data we used a finite mixture model specification.The data were obtained from the most recent implementation in Portugal of the 2003/2004 Europep Survey. The two-component negative binomial II finite mixture model led to the identification of two different latent classes of health centre users: a low-users class that comprises 88% of patients with an estimated utilization mean of 4.3 GP visits per year and a frequent-users class with an estimated utilization mean of 11.1 visits for the remaining 12% of the population.We failed to find any statistically significant elasticity of time cost utilization, when this variable is measured as the total time spent in the health centre. Regarding the effect of an appointment delay on health centre utilization we concluded that individuals respond to this variable by lowering the number of GP visits. This last finding may have policy implications, which will be discussed at the end of the paper.

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Section: Resultssupporting

confidence: 78%

“…Models with c ¼ 1 and 2 are nested, so it is possible to use LR tests to choose among them [36,42]. Models with c ¼ 1 were rejected, remaining the comparison of c ¼ 2 and 3.…”

Section: Resultsmentioning

confidence: 99%

Section: Econometric Speci¢cationmentioning

confidence: 99%

Section: Econometric Speci¢cationmentioning

confidence: 99%

Section: Econometric Speci¢cationmentioning

confidence: 99%

See 3 more Smart Citations

Utilization of public health centres in Portugal: effect of time costs and other determinants. Finite mixture models applied to truncated samples

Lourenço¹,

Ferreira²

2005

Health Economics

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Resource costing for multinational neurologic clinical trials: methods and results

et al. 1998

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We present the results of a multinational resource costing study for a prospective economic evaluation of a new medical technology for treatment of subarachnoid hemorrhage within a clinical trial. The study describes a framework for the collection and analysis of international resource cost data that can contribute to a consistent and accurate intercountry estimation of cost. Of the 15 countries that participated in the clinical trial, we collected cost information in the following seven: Australia, France, Germany, the UK, Italy, Spain, and Sweden. The collection of cost data in these countries was structured through the use of worksheets to provide accurate and efficient cost reporting. We converted total average costs to average variable costs and then aggregated the data to develop study unit costs. When unit costs were unavailable, we developed an index table, based on a market-basket approach, to estimate unit costs. To estimate the cost of a given procedure, the market-basket estimation process required that cost information be available for at least one country. When cost information was unavailable in all countries for a given procedure, we estimated costs using a method based on physician-work and practice-expense resource-based relative value units. Finally, we converted study unit costs to a common currency using purchasing power parity measures. Through this costing exercise we developed a set of unit costs for patient services and per diem hospital services. We conclude by discussing the implications of our costing exercise and suggest guidelines to facilitate more effective multinational costing exercises.

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Heterogeneity, Excess Zeros, and the Structure of Count Data Models

Mullahy

1997

J. Appl. Econ.

130

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Demand for Medical Care by the Elderly: A Finite Mixture Approach

Cited by 417 publications

References 27 publications

Utilization of public health centres in Portugal: effect of time costs and other determinants. Finite mixture models applied to truncated samples

Utilization of public health centres in Portugal: effect of time costs and other determinants. Finite mixture models applied to truncated samples

Resource costing for multinational neurologic clinical trials: methods and results

Heterogeneity, Excess Zeros, and the Structure of Count Data Models

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