d'Uva, Teresa Bago Lindeboom, Maarten O'Donnell, Owen van Doorslaer, Eddy
Tinbergen Institute Discussion Paper 10-122/3
Reliance on self-rated health to proxy medical need can bias estimation of education-related inequity in health care utilisation. We correct this bias both by instrumenting self-rated health with objective health indicators and by purging self-rated health of reporting heterogeneity identified from health vignettes. Using data on elderly Europeans, we find that instrumenting self-rated health shifts the distribution of doctor visits in the direction of inequality favouring the better educated. There is a further, and typically larger, shift the same direction when correction is made for the tendency of the better educated to rate their health more negatively.
health care health equity reporting heterogeneity vignettes