Reliance on self-rated health to proxy medical need can bias estimation of education-related inequity in healthcare utilization. We correct this bias both by instrumenting self-rated health with objective health indicators and by purging self-rated health of reporting heterogeneity that is identified from health vignettes. Using data on elderly Europeans, we find that instrumenting self-rated health shifts the distribution of visits to a doctor in the direction of inequality favouring the better educated. There is a further, and typically larger, shift in the same direction when correction is made for the tendency of the better educated to rate their health more negatively.

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Keywords Equity, Health, Healthcare, Reporting heterogeneity, Vignettes
Persistent URL dx.doi.org/10.1111/j.1467-985X.2011.00706.x, hdl.handle.net/1765/26679
Citation
Bago d'Uva, T.M., Lindeboom, M., O'Donnell, O.A., & van Doorslaer, E.K.A.. (2011). Education-related inequity in healthcare with heterogeneous reporting of health. Journal of the Royal Statistical Society. Series A: Statistics in Society, 174(3), 639–664. doi:10.1111/j.1467-985X.2011.00706.x