http://repub.eur.nl/res/aut/9099/ List of Publications en http://repub.eur.nl/static-eur/img/logo.png http://repub.eur.nl http://repub.eur.nl/res/pub/16281/ 2010-01-01T00:00:00Z This paper analyses the role of health on exits out of and entries into employment using data from the first twelve waves of the British Household Panel Survey (1991-2002). We use discrete-time duration models to estimate the effect of health on the hazard of becoming non-employed and on the hazard of becoming employed. The results show that general health, measured by a variable that captures health limitations and by a constructed latent health index, affects entries into and exits out of employment; the effects being higher for men than for women. The results are robust to different definitions of employment, and to the exclusion of older workers from the analysis. http://repub.eur.nl/res/pub/26888/ 2009-03-01T00:00:00Z The ECHP is used to analyse health care utilisation care in Europe. We estimate a new latent class hurdle model for panel data and compare it with the latent class NegBin model and the standard hurdle model. Latent class specifications outperform the standard hurdle model and the latent class hurdle model reveals income effects that are masked in the NegBin model. For specialist visits, low users are more income elastic than high users and the probability of using care is more income elastic than the conditional number of visits. The effects of income on total use of GPs are mostly negative or insignificant but positive elasticities are found for Austria, Greece and, to a greater extent, Portugal. On the whole, richer individuals tend to use more specialist care, especially in Portugal, Ireland, Finland, Greece and Austria. Features of the health care systems of these countries may contribute to the observed inequities. http://repub.eur.nl/res/pub/19397/ 2008-01-01T00:00:00Z Measurement of inequity in health care delivery has focused on the extent to which health care utilisation is or is not distributed according to need, irrespective of income. Studies using cross-sectional data have proposed various ways of measuring and standardizing for need, but inevitably much of the inter-individual variation in needs remains unobserved in cross-sections. This paper exploits panel data methods to improve the measurement by including the time-invariant part of unobserved heterogeneity into the need-standardization procedure. Using latent class hurdle models for GP and specialist visits estimated on 8 annual waves of the European Community Household Panel we compute indices of horizontal equity that partition total income-related variation in use into a need- and a non-need related part, not only for the observed but also for the unobserved but time-invariant component. We also propose and compare a more conservative index of horizontal inequity to the conventional statistic. We find that many of the cross-country comparative results appear fairly robust to the panel data test, although the panel-based methods lead to significantly higher estimates of horizontal inequity for most countries. This confirms that better estimation and control for need often reveals more pro-rich distributions of doctor utilisation. http://repub.eur.nl/res/pub/10453/ 2007-08-02T00:00:00Z Measurement of inequity in health care delivery has focused on the extent to which health care utilization is or is not distributed according to need, irrespective of income. Studies using cross-sectional data have proposed various ways of measuring and standardizing for need, but inevitably much of the inter-individual variation in needs remains unobserved in cross-sections. This paper exploits panel data methods to improve the measurement by including the time-invariant part of unobserved heterogeneity into the need-standardization procedure. Using latent class hurdle models for GP and specialist visits estimated on 8 annual waves of the European Community Household Panel we compute indices of horizontal equity that partition total income-related variation in use into a need- and a non-need related part, not only for the observed but also for the unobserved but time-invariant component. We also propose and compare a more conservative index of horizontal inequity to the conventional statistic. We find that many of the cross-country comparative results appear fairly robust to the panel data test, although the panel based methods lead to higher estimates of horizontal inequity for most countries. This confirms that better estimation and control for need often reveals more pro-rich distributions of utilization. http://repub.eur.nl/res/pub/11344/ 2006-02-01T00:00:00Z There is increasing concern that equity in health and health care in Europe may suffer as a result of the expansion of the European Union and the ageing of its populations. This article reviews the findings of the "ECuity III" project: a network of European health economists who have investigated socioeconomic inequalities in health and health care. In order to help inform the policy debate about how to secure health equity in our ageing European societies, the project pays particular attention to the key decisions about income, health and health care in age groups around the retirement age, as these prove to be crucial for a better understanding of cross‐country differences in inequalities. http://repub.eur.nl/res/pub/11347/ 2004-07-01T00:00:00Z http://repub.eur.nl/res/pub/11436/ 2004-07-01T00:00:00Z This paper provides new evidence on the sources of differences in the degree of income-related inequalities in self-assessed health in 13 European Union member states. It goes beyond earlier work by measuring health using an interval regression approach to compute concentration indices and by decomposing inequality into its determining factors. New and more comparable data were used, taken from the 1996 wave of the European Community Household Panel. Significant inequalities in health (utility) favouring the higher income groups emerge in all countries, but are particularly high in Portugal and - to a lesser extent - in the UK and in Denmark. By contrast, relatively low health inequality is observed in the Netherlands and Germany, and also in Italy, Belgium, Spain Austria and Ireland. There is a positive correlation with income inequality per se but the relationship is weaker than in previous research. Health inequality is not merely a reflection of income inequality. A decomposition analysis shows that the (partial) income elasticities of the explanatory variables are generally more important than their unequal distribution by income in explaining the cross-country differences in income-related health inequality. Especially the relative health and income position of non-working Europeans like the retired and disabled explains a great deal of excess inequality. We also find a substantial contribution of regional health disparities to socio-economic inequalities, primarily in the Southern European countries. http://repub.eur.nl/res/pub/11364/ 2003-01-01T00:00:00Z This paper assesses the internal validity of using the McMaster ‘Health Utility Index Mark III’ (HUI) to scale the responses on the typical self-assessed health (SAH) question, “how do you rate your health status in general?” It compares alternative procedures to impose cardinality on the ordinal responses. These include OLS, ordered probit and interval regression approaches. The cardinal measures of health are used to compute and to decompose concentration indices for income-related inequality in health. These results are validated by comparison with the individual variation in the ‘benchmark’ HUI responses obtained from the Canadian ‘National Population Health Survey 1994–1995’. The interval regression approach, which exploits a mapping from the empirical distribution function (EDF) of HUI into SAH, outperforms the other approaches. In addition, we show how the method can be extended to allow for differences in SAH thresholds across different groups of people and to measuring and decomposing ‘pure’ health inequality.