Health care utilization and immigration in Spain

Muñoz de Bustillo, Rafael and Antón, José-Ignacio (2009): Health care utilization and immigration in Spain.

Abstract

The aim of this work is to analyze the use of health care services by immigrants in Spain. Using a nationally representative health survey from 2006-2007 that allows overcoming problems present in previous studies and negative binomial and hurdle models, it is found that there is no statistically significant difference in the patterns of visits to physicians and hospital stays between migrants and natives in Spain. However, immigrants have a lower access to specialists and visit emergency rooms with higher frequency than nationals.

• Item Type: MPRA Paper
• Language: English
• Keywords: health care; immigration; Spain; access; equity
• Subjects: F - International Economics > F2 - International Factor Movements and International Business > F22 - International Migration; I - Health, Education, and Welfare > I1 - Health > I10 - General

References

Abásolo, I. (1998): “Equidad horizontal en la distribución del gasto público en sanidad por grupos socioeconómicos en Canarias: Un estudio comparado con el conjunto español”, Hacienda Pública Española, 147(4), 1473-27.

Abásolo, I., Manning, R. and Jones, A.M. (2001): “Equity in Utilization of and Access to Public-Sector GPs in Spain”, Applied Economics, 33(3), pp. 349-364.

Álvarez, B. (2001): “La demanda atendida de consultas médicas y servicios urgentes en España”, Investigaciones Económicas, 25(1), 93-138.

Bach, P.B., Pham, H.H., Schrag, D., Tate, R.C. and Hargraves, J.L. (2004): “Primary Physicians Who Treat Blacks and Whites”, The New England Journal of Medicine, 5(6), 575-584.

Bilger, M. and Chaze, J.P. (2008): “What Drives Individual Health Expenditure in Switzerland”, Swiss Journal of Economics and Statistics, 144(3), 337-358.

Boeri, T.; Hanson, G. and McCormick, B. (2002): Immigration Policy and the Welfare System, Oxford: Oxford University Press.

Borjas, G.J. and Trejo, S.J. (1991): “Immigrant Participation and the Welfare System”, Industrial and Labor Relations Review, 44(2), 195-211.

Burón, Aandrea; Cots, Francesc; García, Óscar; Vall, Oriol y Castells; Xavier (2008): “Hospital emergency department utilization rates among the immigrant population in Barcelona, Spain”, BMC Health Services Research, 8(51).

Cameron, A.C. and Trivedi, P.K. (1998): Regression analysis of count data, New York: Cambridge University Press. Cameron, A.C. and Trivedi, P.K. (2005): Microeconometrics. Methods and Applications, New York: Cambridge University Press.

Canal-Domínguez, J. and Rodríguez-Gutiérrez, C. (2008): “Analysis of wage differentials between native and immigrant workers in Spain”, Spanish Economic Review, 10(2), 109-134.

Cantarero, D. and Pascual, M. (2008): “Inmigración, Salud y Utilización en España”, paper presented at the 15th Conference in Public Economics, Salamanca (Spain), February 7-8.

Centro de Investigaciones Sociológicas (CIS) (2006) Barómetro Septiembre 2006, Madrid: CIS.

Clavero, A. and González, M.L. (2005): “La demanda de asistencia sanitaria en España desde la perspectiva de la decisión del paciente”, Estadística Española, 47(158), 55-87.

Cots, Francesc; Castells, Xavier; García, Óscar; Riu, Marta; Aida, Felipe and Vall, Oriol (2007): “Impact of immigration on the cost of emergency visits in Barcelona (Spain)”, BMC Health Services Research, 7(9).

Cotter, J. (2008): “The Determinants of Health Care Use Utilization in Portugal: An Approach with Count Data Models”, Swiss Journal of Economics and Statistics, 144(3), 437-458.

European Commission (2006): Eurobarometer 66. Full Report, Brussels: European Commission.

Fernández, C. and Ortega, A.C. (2008): “Labor market assimilation of immigrants in Spain: employment at the expense of bad job-matches?”, Spanish Economic Review, 10(2), 83-107.

García, P., González, S. and Sáez, M. (2007): “Diferencias en estado de salud y en los condicionantes de utilización de los servicios sanitarios entre la población de origen extranjero”, en Argullol i Morgadas, E. and López i Casanovas, G. (dirs.) Inmigración y transformación social en Cataluña, Bilbao: Fundación BBVA, 257-304.

Gerdtham, U.G. (1997): “Equity in health care utilization: further evidence based on hurdle models and Swedish micro data”, Health Economics, 6(3), 303-319.

Gerdtham, U.G. and Trivedi, P.K. (2001): “Equity in Swedish health care reconsidered: new results based on the finite mixture model”, Health Economics, 10(6), 565-572.

Gould, W., Pitblado, J. and Sribney, W. (2006): Maximum Likelihood Estimation with Stata, 3rd edition, College Station, Texas: Stata Press.

Greene, W.G. (2008): Econometric Analysis, 6th edition, New Jersey: Pearson.

Greene, W.H. (1995): LIMDEP Version 7.0 User’s Manual, Bellport, New York: Econometric Software, Inc.

Grogger, J.T. and Carson, R.T. (1991): “Models for truncated counts”, Journal of Applied Econometrics, 6(3), 225-238.

Grossman, M. (1972), “On the concept of health capital and demand for health”, Journal of Political Economy, Vol. 80, No. 2, pp. 223-255.

Hansen, M. and Lofstrom, J. (2003): “Immigrant Assimilation and Welfare Participation: Do Immigrants Assimilate Into or Out of Welfare?”, Journal of Human Resources, 38(1), 74-98.

Hjern, A., Haglund, B., Persson, G. and Rosén, M. (2001): “Is there equity in access to health care ethnic minorities in Sweden”, European Journal of Public Health, 11(2), 147-152.

Instituto de Salud Pública de Madrid (2005): Encuesta de Salud de la Ciudad de Madrid 2004-2005, Madrid: Instituto de Salud Pública de Madrid.

Instituto de Salud Pública de Madrid (2005): Encuesta de Salud de la Ciudad de Madrid 2004-2005, Madrid: Instituto de Salud Pública de Madrid.

Jiménez-Martín, S.; Labeaga, J.M. and Martínez-Granado, M. (2004): “An empirical analysis of the demand for physician services across the European Union”, European Journal of Health Economics, 5(2), 150-165.

Jones, A.M. (2000): “Health Econometrics”, in Newhouse, J.P. and Culyer, A.J. (eds.) Handbook of Health Economics, 1A, Amsterdam: Elservier, 265-344.

Jones, A.M. (2007): Applied Econometrics for Health Economists: A Practical Guide, 2nd edition, Oxford: Office of Health Economics.

Krasnik, A., Norredam, M., Sorensen, T.M., Michaelsen, J.J., Nielsen, A.S. and Keiding, N. (2002): “Effect of ethnic background on Danish hospital utilization Patterns”, Social Science & Medicine, 55(7), 1207-1211.

Laroche, M. (2000): “Health Status and Health Services Utilization of Canada’s Immigrant and Non-Immigrant Population”, Canadian Public Policy/ Analyse de Politiques, 26(1), 51-75.

Mullahy, J. (1986): “Specification and testing of some modified count data models”, Journal of Econometrics, 33(3), 341-365.

Muñoz de Bustillo, R. and Antón, J.I. (2007): “Inmigración y Estado de Bienestar. Una aproximación al caso español”, en Domínguez, R. (coord.) Inmigración: crecimiento económico y bienestar social, Santander: Universidad de Cantabria and Parlamento de Cantabria, 117-146.

Muurinen, J. M. (1982), “Demand for health: A generalised Grossman model”, Journal of Health Economics, 1(1), 5-28.

Navarro, V. (dir.) (2004): El Estado de Bienestar en España, Madrid: Tecnos.

Pohlmeier, W. and Ulrich, V. (1995): “An Econometric Model of the Two-Part Decisionmaking Process in the Demand for Health Care”, Journal of Human Resources, 30(2), 339-361.

Primoff, J. (1997): “Gender differences in days lost from work due to illness”, Industrial and Labor Relations Review, 50(2), 304-323.

Rivera, B. (2005), “Inmigración y Atención Sanitaria en España: Impacto sobre los Sistemas de Salud de las Comunidades Autónomas”, paper presented at the the Conference of the Spanish Health Economics Association 2005, November 1-5, Gran Canaria, Spain.

Rodríguez, M. and Stoyanova, A. (2004): “The effect of private insurance access on the choice of GP/specialist and public/private provider in Spain”, Health Economics, 13(7), 689-703.

Romero-Ortuño, R. (2004): “Access to health care for illegal immigrants in the EU: should we be concerned”, European Journal of Health Law, 11(3), 245-272.

Rosen, A.B., Tsai, J.S. and Downs, S.M. (2003): “Variations in Risk Attitude across Race, Gender, and Education”, Medical Decision Making, 23(6), 511-517.

Sander, M. (2008): “Is there migration-related inequity in access to or in the utilization of health care in Germany”, SOEP Papers on Multidisciplinary Panel Data Research, 147.

Szabó, T. (1997): La demanda de seguros médicos privados y el uso servicios sanitarios en España, Msc Dissertation, 9706, Center for Monetary and Financial Studies.

Urbanos, R.M. (2000): “La prestación de los servicios sanitarios públicos en España: cálculo y análisis de la equidad horizontal interpersonal para el período 1987-1995”, Hacienda Pública Española, 153(2), 139-160.

Van Houtven, C.H.; Voils, C.I.; Oddone, E.Z., Weinfurt, K.P., Friedman, J.Y., Schulman, K.A. and Bosworth, H.B. (2005): “Perceived Discrimination and Reported Delay of Pharmacy Prescriptions and Medical Tests”, Journal of General Internal Medicine, 20(7), 578-583.

Vera-Hernández, A.M. (1999): “Duplicate coverage and demand for health care. The case of Catalonia”, Health Economics, 8(7), 579-598.

Wagstaff, A. (1986), “The Demand for Health: A Simplified Grossman Model”, Bulletin of Economic Research, 38(1), 93-95.

Waidman, T.A. and Rajan, S. (2000): “Race and ethnic disparities in health care access and utilization: an examination of state variation”, Medical Care Research Review, 57(1), 55-84.

Weinik, R., Zuvekas, S. and Cohen, J. (2005): “Racial and ethnic discrimination in access to and use of health services, 1977 to 1996”, Medical Care Research Review, 57(1), 36-54.

Windmeijer, F. and Santos Silva, J. (1997): “Endogeneity in Count Data Models: An Application to Demand for Health Care”, Journal of Applied Econometrics, 12(3), 281-294.

Winkelmann, R. (2002): “Work and health in Switzerland: Immigrants and Natives”, Socioeconomic Institute, University of Zurich, Working Paper 203.

Wooldridge, J.M. (2002): Econometric Analysis of Cross-Section and Panel Data, MIT: The MIT Press.

Zweifel, P. (1981): “Supplier-induced demand in a model of physician behavior”, in van der Gaag, J. and Perlman, M. (eds.) Health, Economics, and Health Economics, New York: North Holland, 245-267.