A Dynamic Stochastic Model of Medical Care Use and Work Absence

  title={A Dynamic Stochastic Model of Medical Care Use and Work Absence},
  author={Donna B Gilleskie},
This research explores the medical care consumption and absenteeism decisions of employed individuals with acute illnesses in an effort to better understand health care behavior. Using data from the 1987 National Medical Expenditure Survey, the author estimates the structural parameters of an individual's discrete choice stochastic optimization problem, as opposed to employing conventional reduced form estimation methods that are prevalent in the health care literature. The estimates allow for… Expand
This paper models individual medical care consumption over an insurance year, explicitly accounting for variations in the effective price of medical care due to several characteristics of the healthExpand
Reference Health and the Demand for Medical Care
We propose that health in prior periods, termed reference health, is theoretically and empirically relevant to the demand for medical care. To address non‐normality in the distributions of medicalExpand
Work absences and doctor visits during an illness episode: The differential role of preferences, production, and policies among men and women
This paper analyzes the absenteeism and medical care consumption behavior of employed men and women during an episode of acute illness. An individual's daily optimization decisions are modeled in aExpand
Health Insurance, Medical Care, and Health Outcomes
This work model the dynamic supplemental health insurance decisions of Medicare beneficiaries, their medical care demand, and subsequent health outcomes over time, using parameter estimates obtained with longitudinal individual-level data to simulate behavior under different drug coverage scenarios. Expand
The Role of Retiree Health Insurance in the Employment Behavior of Older Men
Using data from the Health and Retirement Survey, we estimate preference and expectations parameters of a structural model of the employment and medical care decisions of older men in order toExpand
Change Matters: Empirical Tests of the Dynamic Demand for Medical Care 1
Single period models of the demand for medical care assume individuals make myopic decisions about their health. Single equation models assume that the demands for medical care and other consumptionExpand
The effect of managed care on use of health care services: results from two contemporaneous household surveys.
The paper exploits recent advances in simulation-based econometrics to take the endogeneity of enrollment into managed care plans into account and identify the causal relationship between managed care enrollment and utilization. Expand
Waiting for health care and duration of sick leave
The results indicate that almost all waiting for health care variables have a statistically significant positive impact on the duration of sick leave, and did not induce substantial changes on the impact of traditional variables of the labor supply model. Expand
Asymmetric information in health insurance: evidence from the National Medical Expenditure Survey.
A structural model of health insurance and health care choices using data on single individuals from the NMES is estimated and it is found that riskier types buy more coverage and, on average, end up using more care. Expand
Moral hazard in health insurance: a dynamic model of within-year medical care consumption
Asymmetric information in health insurance markets may lead individuals to overconsume medical care. Many studies explore this \moral hazard" using models that aggregate medical care decisions up toExpand


A Microeconometric Model of the Demand for Health Care and Health Insurance in Australia
This paper develops a model for interdependent demand for health insurance and health care under uncertainty to throw light on the issue of insurance-induced distortions in the demand for health careExpand
Uncertainty and the demand for medical care.
Comparative static results are reported indicating the effects on the demand for medical care of both increases in the means of these distributions and mean-preserving spreads of the distributions. Expand
Cost Sharing and Patterns of Mental Health Care Utilization
Deductibles and coverage ceilings are common features of health insurance. This paper proposes and tests a new method for estimating the impact of these health coverage features on demand when totalExpand
Health insurance and the demand for medical care: evidence from a randomized experiment.
This work estimates how cost sharing, the portion of the bill the patient pays, affects the demand for medical services and rejects the hypothesis that less favorable coverage of outpatient services increases total expenditure. Expand
The demand for episodes of mental health services.
It is found that outpatient mental health use is more responsive to price than is outpatient medical use, but not as responsive as most observational studies have indicated. Expand
The demand for episodes of treatment in the Health Insurance Experiment.
Analysis of claims data from the RAND Insurance Experiment complements analyses of annual medical spending by revealing more about how decisions to spend are made within the year. Expand
Rational behavior in the presence of coverage ceilings and deductibles
Consumers of health care services with insurance plan features such as deductibles, copayments, and coverage ceilings, in which the price of health care depends upon expenditures accumulated during aExpand
Allocating health expenditures to treatment and prevention.
  • D. Heffley
  • Economics, Medicine
  • Journal of health economics
  • 1982
The suggested approach imbeds a Markov model of the disease process in a simple budget-constrained nonlinear program, suggesting the need for a flexible policy stance until the parameters of such models can be estimated. Expand
How Social Security and Medicare affect retirement behavior in a world of incomplete markets
This paper provides an empirical analysis of how the U.S. Social Security and Medicare system affects the labor supply of older males in the presence of incomplete markets. The authors estimate aExpand
Job Exit Behavior of Older Men
A dynamic programming model of job exit behavior and retirement is constructed and estimated using the method of simulated moments. The model and estimation method allow for both unobservedExpand