ArticleBMC public health2020
Income and wealth as determinants of voluntary private health insurance: empirical evidence in Spain, 2008-2014.
Article in BMC public health, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers, 1 of them a synthesis that pooled it.
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Who cites it
14 citing papers in PubMed, 1 synthesis or guideline pooled it.
- The relationship between health insurance and economic performance: an empirical study based on meta-analysis.Frontiers in public health · 2024Pooled it
- Catastrophic health expenditure and commercial health insurance purchase: evidence from China.BMC health services research · 2026Article
- National Health Insurance Role in Hospital Utilisation in Disadvantaged Areas: Evidence from Indonesia.The Malaysian journal of medical sciences : MJMS · 2024Article
- Premature Death, Suicide, and Nonlethal Intentional Self-Harm After Psychiatric Discharge.JAMA network open · 2024Article
- Factors associated with the enrollment of commercial medical insurance in China: Results from China General Social Survey.PloS one · 2024Article
- Financial Knowledge and Private Health Insurance: Does Age Matter?Healthcare (Basel, Switzerland) · 2023Article
- Research on the Effect of Commercial Health Insurance Development on Economic Efficiency.International journal of environmental research and public health · 2023Article
- [Characteristics of the migrant women attended by the Reproductive Health Care Services of the Catalan Health Institute.]Revista espanola de salud publica · 2023Article
- Uptake of health insurance in Malawi in 2019-2020: evidence from the multiple indicator cluster survey.The Pan African medical journal · 2023Article
- Private Health Insurance and Financial Risk Taking in Spain-The Moderating Effect of Subjective Risk Tolerance.International journal of environmental research and public health · 2022Article
- Price elasticity of demand for voluntary health insurance plans in Colombia.BMC health services research · 2022Article
- Health insurance status and its determinants among patients with type 2 diabetes mellitus in a tertiary teaching hospital in Malaysia.PloS one · 2022Article
- Utilization of Parallel Resources and Sociodemographic Factors in Treating Children with Complex Chronic Diseases: A Cross-Sectional Study.Children (Basel, Switzerland) · 2021Article
- Health Insurance Ownership among Moluccans in Indonesia.Indian journal of community medicine : official publication of Indian Association of Preventive & Social MedicineArticle
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Authors and funding
2 authors.
Funding
Abstract
backgroundFew studies have quantitatively estimated the income elasticity of demand of voluntary private health insurance (VPHI) in countries with a universal National Health Service. Most studies to date have uses cross-sectional data.
methodsIn this paper we used a longitudinal database from the Bank of Spain to analyse the financial behaviour of approximately six thousand families per wave. We used three waves (2008, 2011 and 2014). We estimated income and wealth semi-elasticities of VPHI in Spain considering personal and family characteristics (age, sex, level of health, education, composition of the household), i.e. changes in the probability of buying VPHI as result of 1% change in income or wealth. We estimated cross-sectional models for each wave and longitudinal models for families remaining for at least two waves, taking account of possible selection bias due to attrition.
resultsCross-sectional models suggest that the income effect on the probability of buying a VPHI increased from 2008 to 2014. The positive impact was observed for, wealth. In 2008 a 1% increase in income is associated with an increase in the probability of having VPHI of 0.064 [95%-CI: 0.023; 0.104] - on the probability scale (0.1) - whereas in 2014, this effect is of 0.116 [95%-CI, 0.094; 0.139]. In 2011 and 2014 the wealth effect is not significant at 5%. The estimation of the longitudinal model leads to different results where both, income and wealth are associated with non- significant results.
conclusionOur three main conclusions are: 1) Cross-sectional estimates of semi-elasticities of VPHI might be biased upwards; 2) Wealth is alongside income are economic determinants, of the decision to buy VPHI in high-income countries; 3) The effects of income and wealth on the probability of buying VHPI are neither linear nor log-linear. There are no significant differences among 60% of the most disadvantaged families, while the families of the two upper wealth quintiles show clearly differentiated behaviour with a higher probability of insurance.
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