This paper uses the British Health and Lifestyle Survey (1984-1985) data and the longitudinal follow-up of May 2003 to investigate the determinants of premature mortality risk in Great Britain. A behavioral model, which relates premature mortality to a set of observable and unobservable factors, is considered. We focus on unobservable individual heterogeneity and endogeneity affecting the mortality equation. A MSL approach for a multivariate probit (MVP) is used to estimate a recursive system of equations for deaths and lifestyles. This model is then compared with the univariate probit models that include or exclude lifestyles. In order to detect inequality in the distribution of health within the population and to calculate the contribution of socioeconomic factors, we compare the range measure of health inequality to the Gini coefficient for overall health inequality. A Gini decomposition analysis for predicted premature mortality shows that endogenous lifestyles and unobservable heterogeneity strongly contribute to inequality in mortality, reducing the role of socio-economic status. JEL codes I1 C0
This paper investigates long-term home care utilization in Europe. Data from the first wave of the Survey on Health, Ageing and Retirement (SHARE) on formal (nursing care and paid domestic help) and informal care (support provided by relatives) are used to study the probability and the quantity of both types of care. The overall process is framed in a fully simultaneous equation system that takes the form of a bivariate two-part model where the reciprocal interaction between formal and informal care is estimated. Endogeneity and unobservable heterogeneity are addressed using a common latent factor approach. The analysis of the relative impact of age and disability on home care utilization is enriched by the use of a proximity to death (PtD) indicator built using the second wave of SHARE. All these indicators are important predictors of home care utilization. In particular, a strong significant effect of PtD is found in the paid domestic help and informal care models. The relationship between formal and informal care moves from substitutability to complementarity depending on the type of care considered, and the estimated effects are small in absolute size. This might call for a reconsideration of the effectiveness of incentives for informal care as instruments to reduce public expenditure for home care services.
No abstract
Interregional patient mobility in a decentralized healthcare system. Regional Studies. Interregional patient mobility,\ud measured as origin–destination patient flows between any two regions, is analysed within a dynamic spatial panel data\ud framework using 2001–10 data on Italian hospital discharges. The aim is to assess the effects of the main determinants\ud of patient flows, distinguishing between the impacts of regional health policies and those exerted by exogenous factors\ud (geography, size, neighbouring regions, national policies). Empirical results indicate that the main drivers of mobility are\ud regional income, hospital capacity, organizational structure, performance and technology. Moreover, neighbouring\ud regions’ supply factors, specialization and performance largely affect mobility by generating significant local externalities
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