Determinants of access to physician services in Italy: a latent class seemingly unrelated probit approach

Abstract

We examine access to general practitioners and specialists who work in the public and private sectors in Italy using a seemingly unrelated system of probits. We use a latent class formulation that provides a rich and flexible functional form and can accommodate non-normality of response probabilities. The empirical analysis shows that patient behavior can be clustered in two latent classes. We find that income strongly influences the mix of services. Richer individuals are less likely to seek care from GP's and more likely to seek care from specialists, and especially private specialists. Health status and societal vulnerability are the most important indicators of class membership.

Uncontrolled diabetes and health care utilisation: A bivariate latent Markov model approach

“…The analysis of the determinants of health care utilisation has received considerable attention within the empirical economics literature. Early studies employ hurdle (e.g., Jimenez-Martin et al, 2002;Pohlmeier & Ulrich, 1995;Santos Silva & Windmeijer, 2001;Schellhorn et al, 2000;Van Ourti, 2004) and finite mixture models (e.g., Atella et al, 2004;Deb & Holmes, 2000;Deb & Trivedi, 1997;Deb & Trivedi, 2002;Jimenez-Martin et al, 2002) to explore the factors influencing health care use mainly on cross-sectional data. More recent papers exploit panel data and propose latent class models that account for individual-level unobserved heterogeneity (e.g., Bago d'Uva, 2005) as well as combinations of hurdle and latent class models (e.g., Bago d'Uva, 2006;Bago d'Uva & Jones, 2009).…”

Choices and utilization in dental care

“…Wom en and stu dents are more like ly to con tact a den tist. The ef fects curs with the oth er stud ies on choic es of providers and ser vice sec tors [8,23]. Be ing reg u lar ly re called by the den tist was found to be more im por tant than pub lic sub sidy as a means of in creas ing de mand [21].…”

“…In come has been shown to have a pos itive ef fect on ac cess to den tal care [5] and to hos pi tal care [6], on the use of med i cal spe cial ists' ser vices [7], and on the choice of a med i cal spe cial ist as op posed to a gener al prac ti tio ner and also the sub se quent choice of ei ther pub lic or pri vate spe cialist [8]. Choic es be tween pub lic and pri vate health care in the Unit ed King dom [9] and the choice of den tal sec tors in Fin land [10] have been ex am ined.…”

“…It was found that most of the vis its to pub lic den tists in Fin land in 1996 were made by the low est in come groups, while most of those to pri vate den tists were made by the high est in come groups [1]. More over, over the past two decades high er in come in divid u als in Fin land have used den tal care ser vices more than their low er in come coun ter parts [1,2,3,4].In come has been shown to have a pos itive ef fect on ac cess to den tal care [5] and to hos pi tal care [6], on the use of med i cal spe cial ists' ser vices [7], and on the choice of a med i cal spe cial ist as op posed to a gener al prac ti tio ner and also the sub se quent choice of ei ther pub lic or pri vate spe cialist [8]. Choic es be tween pub lic and pri vate health care in the Unit ed King dom [9] and the choice of den tal sec tors in Fin land [10] have been ex am ined.…”

Analysis of Health Care Costs in Elderly Patients with Multiple Chronic Conditions Using a Finite Mixture of Generalized Linear Models

“…Batscheider et al (2014) applied a latent growth mixture model to examine the development of healthcare costs in relation to body mass index (BMI) in German children. Yet, mixtures of alternative densities have been used rarely to estimate heath care costs, although this approach has been claimed to be superior to traditional estimation techniques (Deb et al, 2003;Atella et al, 2004;Munkin and Trivedi, 2010).…”