Effect of having private health insurance on the use of health care services: the case of Spain

Background: Several stakeholders have undertaken initiatives to propose solutions towards a more sustainable health system and Spain, as an example of a European country affected by austerity measures, is looking for ways to cut healthcare budgets. Methods: The aim of this paper is to study the effect of private health insurance on health care utilization using the latest micro-data from the European Community Household Panel (ECHP), the Spanish National Health Survey (SNHS) and the European Union Statistics on Income and Living Conditions (EU-SILC). We use matching techniques based on propensity score methods: single match, four matches, bias-adjustment and allowing for heteroskedasticity. Results: The results demonstrate that people with a private health insurance, use the public health system less than individuals without double health insurance coverage. Conclusions: Our conclusions are useful when policy makers design public-private partnership policies

Socio-economic status and health: evidence from the ECHP

In this paper, the effects of socioeconomic characteristics (gender, age, education level, marital status, income, occupational and health status, household size and social relationships) on individuals' health status in spain from 1994 to 2001 are analysed. The estimations are carried out using ordered probit models and new data from de whole waves of the European Community Household Panel (ECHP) have been used. The results indicate that personal characteristics, education level, income as well as health status and social relationships have strong influence on shelf-assessed health

Analysing health limitations in Spain: an empirical approach based on the european community household panel

During the last years, policy makers have shown an increasing interest in social inclusion issues and reintegration policies for people with disabilities. However, disabled people are at a high risk of being unemployed. This paper is focused on labour market status of those individuals reporting “non-hampered in daily activities by a chronic or mental health problem, illness or disability”, using currently available data from large-scale representative surveys. In particular, we have used the information contained in the European Community Household Panel (ECHP)

Obesity and socio-economic inequalities in Spain: evidence from the ECHP.

This paper explores the relationship between obesity, measured by the Body Mass Index (BMI), and socio-demographic characteristics in Spain. Empirical work is based on data from the European Community Household Panel (ECHP). The results obtained through probit models show that factors such as age, education, marital status, health status and some economic data are relevant in explaining whether an individual is obese or not

Patient Cross-Border Mobility: New Findings and Implications in Spanish Regions

Spain has a National Health Service with a mixed public-private funded system. In the last decades, a huge effort has gone into reducing barriers to patient migration. We estimate a panel data based on a gravity model of migration since the process of health care decentralization has been completed in Spain. Our empirical results show that income is one of the most important drivers in explaining mobility as well as supply variables. Individual characteristics are not among the main factors for mobility. Besides, it is demonstrated there is a quality-driven mobility in Spain. However, there was no significant difference in the influence on patients? mobility between those living in the North of the country and the Mediterranean regions. The empirical results also suggest that current regional health policies in Spain, that explain patients? mobility, should be associated with greater funding system

Earnings Overlife: Are We Building a New Glass Ceiling?

The recent economic crisis has highlighted and enhanced the long-term value of earnings over life. This paper is focused on the relationship between income and age in Spain. We have considered cohort data using the information contained in the European Union Statistics on Income and Living Conditions (EU-SILC). The variation of earnings with age follows a quadratic function, reaches a maximum at age 48 years old and declines thereafter. The evidence found has important effects on retirement decisions and also confirms the existence of a significant gender gap. Also, we can accept the existence of a new glass ceilin

Have Health Inequalities Increased during the COVID-19 Pandemic? Evidence from Recent Years for Older European Union Citizens

Reducing inequality is one of the current challenges that most societies are facing. Our aim was to analyze the evolution of inequalities in self-assessed health among older Europeans in a time period spanning the 2008 economic crisis and the COVID-19 health crisis. We used data from Waves 2, 4 and 8 of the Survey of Health, Ageing and Retirement in Europe. We used inequality indices that accept ordinal variables. Our empirical results suggest that average inequality declines over time. Gender significantly influences the results. Some of the countries with the highest level of inequality are Denmark and Sweden, and some with the lowest are Estonia and the Netherlands. Our results may be of interest for the development of public policies to reduce inequalities. Special attention should be paid to vulnerable groups, such as the elderly

Okun's Law in Selected European Countries (2005-2017): An Age and Gender Analysis

ABSTRACT. In this paper the robustness of the Okun's relationship is tested using data from a group of selected European countries during the period 2005-2017, considering different age cohorts and gender. Four macroareas based on geographic location are also considered: Continental Europe, Nordic countries, Southern Europe, and Anglo-Saxon countries. Two traditional models are applied, the first difference and the "gap" one. The relevant data for the latter model is constructed from the HodrickPrescott filter. The empirical results indicate that an inverse relationship between unemployment and output holds for the whole sample and subsamples. Besides, it can be highlighted that these countries show smaller output loss associated with higher unemployment. Additionally, our findings suggest that the oldest population tends to be less exposed to the business cycles. Meanwhile, slight differences along countries and macro-areas are found. Therefore, as disparities in productivity growth are showed, different policies are required for each area. Actually, policymakers should design various ways to increase employment opportunities for diverse groups in society (specific coordinated policies for each necessity): those on specific age cohorts, those working in particular economic activities or those living in specific countries or macro-regions

Does social isolation affect medical doctor visits? New evidence among European older adults

ABSTRACT: We have used panel data (2004-2015) from the Survey of Health, Ageing and Retirement in Europe (SHARE) to examine the impact of social isolation on general practitioner health care use. Socio-demographic, health and social isolation measures are analysed. Differences by welfare regimes have been also considered. Using two definitions of social isolation (Alone and Help), we have found that a sizeable proportion of those aged 50 years and older in Europe reported social isolation. Differences by welfare regimes are highlighted. Our findings provide several implications in current debates on the sustainability of welfare states

Social isolation and multiple chronic diseases after age 50: A European macro-regional analysis

Background. Different studies have found that socioeconomic determinants influence the prevalence of chronic diseases in older people. However, there has been relatively little research on the incidence of how social isolation may affect them. We suggest that social isolation is a serious concern for people living with chronic illnesses. Method In this paper, we examine whether there is an increase in the propensity of being diagnosed with chronic illnesses because of a decrease in social relations for elderly Europeans. We have used a panel data for Waves 1±6 (2004±2015) of Survey on Health, Ageing and Retirement in Europe (SHARE) and logistic regressions. Besides, we have studied three geographic macro-areas (Nordic, Continental and Southern). Being diagnosed with three or more chronic diseases is considered as a dependent variable, and as social control variables we have used three isolation proxies (living alone, providing help to family, friends or neighbours and participation-club activities). Other socio-demographic variables are included (gender, age, educational level, job situation, area of location and quality of life). Results. Our results for the full sample indicate that people who participate in social activities have fewer probability of suffering from chronic diseases (OR = 0.70, 95% CI 0.54, 0.92). For people who live alone the reverse effect is observed (OR = 1.20, 95% CI 1.04, 1.39). Differences are shown by macro-areas, e.g. providing help (OR = 0.58, 95% CI 0.34, 0.97) isolation proxy is significant for the Nordic macro-area. Club-participation activities and living alone are significant for Continental and Southern macro-areas, respectively (OR = 0.65, 95% CI 0.55, 0.82; OR = 1.46, 95% CI 1.21, 1.77). Conclusions. Social isolation increases the risk of being diagnosed with chronic illnesses. That is, people with greater social participation have lower risk of suffering from multiple chronic diseases