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We contrast the two-part model (TPM) that distinguishes between users and non-users of health care, with a latent class model (LCM) that distinguishes between infrequent and frequent users. In model comparisons using data on counts of utilization from the RAND Health Insurance Experiment (RHIE), we find strong evidence in favor of the LCM. We show that(More)
IMPORTANCE The US Centers for Medicare & Medicaid Services publishes star ratings reflecting Medicare Advantage plan quality to inform enrollment decisions. OBJECTIVE To assess the association between publicly reported Medicare Advantage plan quality ratings and enrollment. DESIGN, SETTING, AND PARTICIPANTS Cross-sectional study of 2011 Medicare(More)
Estimates of health care demand are known to depend on the empirical specification used in the analysis. In this paper, an innovative specification, the finite mixture model (FMM), is employed to estimate the utilization of and expenditures on behavioural health care. Unlike standard specifications, the FMM has the ability to distinguish between distinct(More)
This paper studies the effect of managed care on medical expenditure using a model in which the insurance status is assumed to be endogenous. Insurance plan choice is modeled through the multinomial probit model. The medical expenditure variable, the outcome of interest, has a significant proportion of zeros that are handled using the two-part model,(More)
The aim of this paper is to measure the returns to migration using non-experimental data taking both observed and unobserved characteristics into account. A significant challenge related to migration research and the issues of unobserved heterogeneity is that the standard 2stage least squares estimator (2SLS) is strictly only applicable to situations with(More)
Prenatal care should improve infant health, yet research frequently finds only weak effects. If there are two kinds of pregnancies, 'complicated' and 'normal' ones, then combining these pregnancies may lead prenatal care to appear ineffective. Data from the National Maternal and Infant Health Survey (NMIHS) offers compelling evidence. The standard 2SLS(More)
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(More)
In this paper, we examine the relationships between health care visits to general practitioners, public and private sector specialists using data from Italy, which has a mixed public-private health care system. We develop a simultaneous equations model that allows for the discreteness of measures of utilization and estimate this model using maximum(More)
I have developed a random effects probit model in which the distribution of the random intercept is approximated by a discrete density. Monte Carlo results show that only three to four points of support are required for the discrete density to closely mimic normal and chi-squared densities and provide unbiased estimates of the structural parameters and the(More)
This article analyzes the effect of gatekeeper and network restrictions on use of health-care services using simulation-based estimation methods. Data from the Community Tracking Survey (1996-1997) show significant evidence of selection into plans with gatekeeper and/or network restrictions. Enrollees in plans with networks of physicians have fewer(More)