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Economic determinants of the distribution of health and health care in Europe


* To examine the role of financial factors - especially user charges, private insurance and income - in determining individuals' utilisation of health services.
* To examine the determinants of private insurance and the existence of adverse selection in the health insurance market.
* To examine the extent of, and the role of economic factors in generating inequalities in health.

Brief description:
The project is a response to the concerns that have been expressed in several European countries over the possible adverse consequences, in terms of both equity in health care utilisation and inequalities in health, of the continued growth of user charges, private health insurance and income inequality. The first aim of the project is to explore the role of user charges, private insurance and income in influencing health care utilisation in various European countries. The structure of user charges will be analysed, especially their relationship with income, as will the effect of user charges of the poor and those in higher income groups and to the variation across countries in the impact of user charges on utilisation. The effects of private insurance (moral hazard) and income will also be explored, again in a comparative context. The second aim of the project is to establish the economic determinants of the demand for private health insurance. This has an important equity dimension in its own right but is also important given the scope for choice of insurance coverage and the need to take this into account when trying to estimate the moral hazard effect. One of the factors to e explored in this work is the possibility that high anticipated expenditures may encourage people to demand private insurance (adverse selection). As in the case of the first objective, the aim is to shed light on cross-country differences as well as country-specific factors.
The third aim of the project is to compare the levels of inequalities in health in the European countries and to establish the role of economic factors in accounting for (a) cross-country differences in health inequality and (b) intra-country health variations. Statistical tests will be conducted to ascertain the statistical significance of cross-country differences. The analyses of the economic determinants of health and health inequalities will involve the estimation of micro and macro-econometric models of the demand for health.

Demand for health and health care, user charges, private health insurance, equity, inequalities in health.


50,Burgermeester Oudlaan 50
3000 Rotterdam