2019, Volume 72 - Issue 1
RSS feed citation: At RePEc
Publication date: 01 February 2019
STUDY ON THE CAUSALITY NEXUS BETWEEN MACRO-ECONOMIC VARIABLES USING VECTOR ERROR CORRECTION MODELINGRead the article
REMITTANCES AND FOREIGN AIDS: SUBSTITUTES OR COMPLEMENTS IN THE ECONOMICS GROWTH OF DEVELOPING COUNTRIES?Read the article
FOREIGN DIRECT INVESTMENTS, EXPORTS AND ECONOMIC GROWTH IN SIDS: EVIDENCE FROM SANTA LUCIARead the article
TIME SERIES ANALYSIS USING ARIMA MODELS: AN APPROACH TO FORECASTING HEALTH EXPENDITURES IN USARead the article
Nadeem A. BURNEY, Techno-Economic Division, Kuwait Institute for Scientific Research
Nadia AL-MUSALLAM, Techno-Economics Division, Kuwait Institute for Scientific Research
Mohammad ALENEZI, Techno-Economics Division, Kuwait Institute for Scientific Research
Salwa HAMADA, Techno-Economics Division, Kuwait Institute for Scientific Research
The growing demand for medical care services (MCS) presents a major policy challenge for health authorities, particularly in the developing countries, as they attempt to manage resources for the health care delivery system. While the empirical literature on the subject has covered both the developed and the developing countries, one region that has been neglected or underrepresented is the oil exporting countries of the Middle East, a region that is different from other countries in terms of its socio-economic-demographic characteristics. This paper investigates determinants of demand for MCS in Kuwait by estimating a two-part model for out-patient services based on data from a household survey on the utilization of health care facilities (HCF) in the country. As the data on the utilization of HCF are known to be afflicted by restricted range, zero values, and skewness, prior to estimating the model, tests were conducted to determine presence of over-dispersion in the data and select an appropriate distribution of the dependent variable for the second part of the model. In addition, test was performed to determine if differences in the estimated coefficients across population groups were statistically significant. The findings of the study are expected to help authorities in Kuwait as well as other oil-exporting economies that share socio-economic and demographic characteristics and experience similar trends in the demand for MCS in formulating policies for the development of health care delivery system.
Medical Care Services, Utilization, Demand, Two-Part Model (TPM), Kuwait
Akin, J. S., C.C. Griffin, D.K. Guilkey and B.M. Popkin (1986), “The Demand for Primary Health Care Services in the Bicol Region of the Philippines”, Economic Development and Cultural Change, 34(4), 755-782.
Al-Amri, Y., M. MacAskill, T. Anderson and H. Benamer (2015), “Parkinson’s Disease in the Gulf Countries: An Updated Review”, European Neurology, 74(3-4): 222-225.
Al-Hamdan, N., K. Ravichandran, J. Al-Sayyad, J. Al-Lawati, Z. Khazal, F. Al-Khateeb, A. Abdulwahab and A. Al-Asfour (2009), “Incidence of Cancer in Gulf Cooperation Countries, 1998 – 2001”, Eastern Mediterranean Health Journal, 15(3), 600-611.
Al-Jefree, N. and F. Ahmed (2015), “Prevalence of Cardiovascular Disease and Associated Risk Factors Among Adult Population in the Gulf Region: A Systematic Review”, Advances in Public Health, 2015, 1-23.
Al-Nohair, S. (2014), “Obesity in Gulf Countries”, International Journal of Health Sciences, 8(1), 79-83.
Babazono, A., K. Kuwabara, A. Hagihara, E. Yamamoto and A. Hillman (2008), “Does Income Influence Demand for Medical Services Despite Japan’s ‘Health Care for All’ Policy?”, International Journal of Technology Assessment in Health Care, 24(1), 125-130.
Brown, C.J., J.A. Pagan and E. Rodríguez-Oreggia (2005), “The Decision-making Process of Health Care Utilization in Mexico”, Health Policy 72(1), 81-91.
Cheng, T.C. and F. Vahid (2010), “Demand for Hospital Care and Private Health Insurance in a Mixed Public-private System: Empirical Evidence Using a Simultaneous Equation Modeling Approach”, Working Paper No. 10/25, Health, Econometrics and Data Group, The University of York, Australia.
Christiansen, T., J. Lauridsen and F. Kamper-Jorgensen (2002), “Demand for Private Health Insurance and Demand for Health Care by Privately and Non-privately Insured in Denmark”, Health Economics Paper 2002/1, University of Southern Denmark.
CSB (2014), Annual Statistical Abstract, Central Statistical Bureau, Kuwait.
Deb, P. and P.K. Trivedi (1997), “Demand for Medical Care by the Elderly: A Finite Mixture Approach”, Journal of Applied Econometrics, 12(3), 313-336.
Deb, P. and P.K. Trivedi (2002), “The Structure of Demand for Health Care: Latent Class versus Two-part Models”, Journal of Health Economics, 21(4), 601-625.
Fabbri, D. and C. Monfardini (2003), “Public vs. Private Health Care Services Demand in Italy”, Giornale degli Economisti e Annali di Economia, 62(1), 93-123.
Giuffrida, A., R.F. Iunes and W.D. Savedoff (2005), “Health and Poverty in Brazil: Estimation by Structural Equation Model with Latent Variables”, Technical Note on Health No. 1/2005, Inter-American Development Bank, Washington, DC.
Greene, W.H. (2012), Econometric Analysis, Seventh Edition, Prentice Hall: Boston, USA.
Grossman, M. (1972a), The Demand for Health: A Theoretical and Empirical Investigation, Columbia University Press: New York, USA.
Grossman, M. (1972b), “On the Concept of Health Capital and the Demand for Health”, Journal of Political Economy, 80(2), 223-255.
Gupta, N.D. and J. Greve (2007), Gender Differences in the Demand for Health Care: Do Men Invest Less in their Health than Women, Department of Economics and Business, Aarhus University, Denmark, Paper presented at the 12th annual meeting of the Society of Labor Economist (SOLE), Chicago, USA.
Hassan, A.R., J.C. Jiménez and R.C. Montoya (2010), “The Impact of Subsidized Health Insurance on the Poor in Colombia: Evaluating the Case of Medellin through Endogenous Dummy Models and Propensity Score Matching for Medical Care Utilization”, Technical Report, Department of Economics, EAFIT University, Colombia.
Heller, P.S. (1982), “A Model of the Demand for Medical and Health Services in Peninsular Malaysia”, Social Science & Medicine, 16(3), 267-284.
Hosseinpoor, A.R., M. Naghavi, S.M. Alavian, N. Speybroeck, H.J. Pharm and J. Vega (2007), “Determinants of Seeking Needed Outpatient Care in Iran: Results from a National Health Services Utilization Survey”, Archives of Iranian Medicine, 10(4), 439-445.
IDF (2017), IDF Diabetes Atlas – 8th Edition, International Diabetes Foundation: Brussels, Belgium.
Jones, A.M., N. Rice, T.Bago d’Uva and S. Balia (2007), Applied Health Economics, Routledge: New York, USA.
Kan, M. and W. Suzuki (2006), “The Demand for Medical Care in Japan: Initial Findings from a Japanese Natural Experiment”, Applied Economics Letters, 13(5), 273-277.
Karpa, W. (2007), “The Demand for Private Health Care in Poland”, Unpublished Mimeograph. Centre d’Economie de la Sorbonne, University of Paris, France.
Kenkel, D. (1990), “Consumer Health Information and the Demand for Medical Care”, The Review of Economics and Statistics, 72(4), 587-595.
Lahiri, K. and G. Xing (2004), “An Econometric Analysis of Veterans’ Health Care Utilization Using Two-part Models”, Empirical Economics, 29(2), 431–449.
López-Cevallos, D.F. and C. Chi (2010), “Health Care Utilization in Ecuador: A Multilevel Analysis of Socioeconomic Determinants and Inequality Issues”, Health Policy and Planning, 25(3), 209-218.
Machado, J.A.F. and J.M.C. Santos-Silva (2005), “Quantiles for Counts”, Journal of the American Statistical Association, 100(472), 1226-1237.
Mullahy, J. (1986), “Specification and Testing of Some Modified Count Data Models”, Journal of Econometrics, 33(3), 341-365.
Pohlmeier, W. and V. Ulrich (1995), “An Econometric Model of the Two-part Decision-making Process in the Demand for Health Care”, The Journal of Human Resources, 30(2), 339-361.
Reniers, G. and R. Tesfai (2009), “Health Services Utilization During Terminal Illness in Addis Ababa, Ethiopia”, Health Policy and Planning, 24(4), 312-319.
Rous, J.J. and D.R. Hotchkiss (2003), “Estimation of the Determinants of Household Health Care Expenditures in Nepal with Controls for Endogenous Illness and Provider Choice”, Health Economics, 12(6), 431-451.
Santos-Silva, J.M.C. and F. Windmeijer (2001), “Two-part Multiple Spell Models for Health Care Demand”, Journal of Econometrics, 104(1), 67-89.
Sarma, S. (2009), “Demand for Outpatient Healthcare: Empirical Evidence from Rural India”, Applied Health Economics & Health Policy, 7(4), 265-277.
Sellars, B., M.A. Garza, C.S. Fryer and S.B. Thomas (2010), “Utilization of Health Care Services and Willingness to Participate in Future Medical Research: The Role of Race and Social Support”, Journal of the National Medical Association, 102(9), 776-786.
Stoyanova, A.P. (2001), “Demand for Utilization of Dental Services: An Empirical Study of the Spanish Dental Care Market”, 21st Jornadas de Economia de la Salud, Oviedo, Spain, June.
UNDP (2015), Human Development Report. United Nations Development Programme, New York, USA.
Wedig, G. (1988), “Health Status and the Demand for Health: Results on Price Elasticities”, Journal of Health Economics, 7(2), 151-163.
Winkelmann, R. (2004), “Health Care Reform and the Number of Doctor Visits: An Econometric Analysis”, Journal of Applied Econometrics, 19(4), 455-472.
Winkelmann, R. (2006), “Reforming Health Care: Evidence from Quantile Regressions for Counts”, Journal of Health Economics, 25(1), 131-145.
Wu, Z. and C.M. Schimmele (2005), “Health Care Utilization of Later-stage Immigrants in British Columbia”, Metrolpolis British Columbia Working Paper Series No. 05-15, Centre of Excellence for Research on Immigration and Integration: Vancouver, Canada.