{"title":"Measuring household vulnerability to medical expenditure shock: method and its empirical application.","authors":"Lei He, Shuyi Zhou","doi":"10.1007/s10754-024-09365-4","DOIUrl":null,"url":null,"abstract":"<p><p>To investigate household vulnerability for inability to cope with medical expenditure shock, we propose a method of measuring household vulnerability to medical expenditure shock by allowing for the heteroscedasticity and dependence of medical expenditure shock and income shock. Using the data from China Health and Nutrition Survey, we estimate the vulnerability of Chinese households, and further investigate crucial characteristics associated with it by comparing the vulnerability levels among groups with different characteristics and an empirical regression with Shorrocks-Shapely decomposition of R squared. Our research shows that health status contributes most to the household vulnerability, and good health helps to reduce the household's vulnerability. Households with stable income and high-education have greater ability to cope with uncertain medical expenditure, and are less vulnerable. Medical insurance plays a limited role in reducing household vulnerability, and the specific type of medical insurance has little influence. All of these findings are conducive to identifying vulnerable households and designing policies to reduce the vulnerability of households.</p>","PeriodicalId":44403,"journal":{"name":"International Journal of Health Economics and Management","volume":" ","pages":"465-480"},"PeriodicalIF":1.5000,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"International Journal of Health Economics and Management","FirstCategoryId":"96","ListUrlMain":"https://doi.org/10.1007/s10754-024-09365-4","RegionNum":4,"RegionCategory":"经济学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/3/7 0:00:00","PubModel":"Epub","JCR":"Q3","JCRName":"BUSINESS, FINANCE","Score":null,"Total":0}
引用次数: 0
Abstract
To investigate household vulnerability for inability to cope with medical expenditure shock, we propose a method of measuring household vulnerability to medical expenditure shock by allowing for the heteroscedasticity and dependence of medical expenditure shock and income shock. Using the data from China Health and Nutrition Survey, we estimate the vulnerability of Chinese households, and further investigate crucial characteristics associated with it by comparing the vulnerability levels among groups with different characteristics and an empirical regression with Shorrocks-Shapely decomposition of R squared. Our research shows that health status contributes most to the household vulnerability, and good health helps to reduce the household's vulnerability. Households with stable income and high-education have greater ability to cope with uncertain medical expenditure, and are less vulnerable. Medical insurance plays a limited role in reducing household vulnerability, and the specific type of medical insurance has little influence. All of these findings are conducive to identifying vulnerable households and designing policies to reduce the vulnerability of households.
为了研究家庭无力应对医疗支出冲击的脆弱性,我们提出了一种通过考虑医疗支出冲击和收入冲击的异方差性和依赖性来衡量家庭对医疗支出冲击脆弱性的方法。利用中国健康与营养调查数据,我们估算了中国家庭的脆弱性,并通过比较不同特征群体的脆弱性水平,以及对 R 平方进行 Shorrocks-Shapely 分解的实证回归,进一步研究了与之相关的关键特征。我们的研究表明,健康状况对家庭脆弱性的影响最大,良好的健康状况有助于降低家庭的脆弱性。收入稳定和受过高等教育的家庭应对不确定医疗支出的能力较强,脆弱性较低。医疗保险在降低家庭脆弱性方面的作用有限,具体的医疗保险类型影响不大。所有这些发现都有利于识别弱势家庭,并制定降低家庭脆弱性的政策。
期刊介绍:
The focus of the International Journal of Health Economics and Management is on health care systems and on the behavior of consumers, patients, and providers of such services. The links among management, public policy, payment, and performance are core topics of the relaunched journal. The demand for health care and its cost remain central concerns. Even as medical innovation allows providers to improve the lives of their patients, questions remain about how to efficiently deliver health care services, how to pay for it, and who should pay for it. These are central questions facing innovators, providers, and payers in the public and private sectors. One key to answering these questions is to understand how people choose among alternative arrangements, either in markets or through the political process. The choices made by healthcare managers concerning the organization and production of that care are also crucial. There is an important connection between the management of a health care system and its economic performance. The primary audience for this journal will be health economists and researchers in health management, along with the larger group of health services researchers. In addition, research and policy analysis reported in the journal should be of interest to health care providers, managers and policymakers, who need to know about the pressures facing insurers and governments, with consequences for regulation and mandates. The editors of the journal encourage submissions that analyze the behavior and interaction of the actors in health care, viz. consumers, providers, insurers, and governments. Preference will be given to contributions that combine theoretical with empirical work, evaluate conflicting findings, present new information, or compare experiences between countries and jurisdictions. In addition to conventional research articles, the journal will include specific subsections for shorter concise research findings and cont ributions to management and policy that provide important descriptive data or arguments about what policies follow from research findings. The composition of the editorial board is designed to cover the range of interest among economics and management researchers.Officially cited as: Int J Health Econ ManagFrom 2001 to 2014 the journal was published as International Journal of Health Care Finance and Economics. (Articles published in Vol. 1-14 officially cited as: Int J Health Care Finance Econ)