Skip to main content
Top
Published in: Health Economics Review 1/2016

Open Access 01-12-2016 | Research

Out-of-pocket expenditure by private households for dental services – empirical evidence from Austria

Authors: Alice Sanwald, Engelbert Theurl

Published in: Health Economics Review | Issue 1/2016

Login to get access

Abstract

Aims

Dental services differ from other health services in several dimensions. One important difference is that a substantial share of costs of dental services–especially costs beyond routine dental treatment–is paid directly by the patient out-of-pocket.

Settings and design

This study analyses the socio-economic determinants of out-of-pocket expenditure for dental services (OOPE) in Austria at the household level.

Methods and material

Cross-sectional information on OOPE and household characteristics provided by the Austrian household budget survey 2009/10 was analysed.

Statistical analysis used

A two-part model (Logit/GLM) and one-part GLM was applied.

Results

The probability of OOPE is strongly affected by the life cycle (structure) of the household. It is higher for higher age classes, higher income, and partially higher levels of education. The type of public insurance has an influence on expenditure probability while the existence of private health insurance has no significant effect. In contrast to the highly statistically significant coefficients in the first stage, the covariates of the second stage remain predominantly insignificant. According to the results, the level of expenditure is driven mainly by the level of education and income. The results of the one-part GLM confirm the results of the two-part model.

Conclusions

The results allow new insights into the determinants of OOPE for dental care. The household level turns out to be an adequate basis to study the determinants of OOPE, although caution should be applied before jumping to conclusions for the individual level.
Appendix
Available only for authorised users
Literature
1.
3.
go back to reference Bilger M, Chaze J-P. What drives individual health expenditure in Switzerland? Swiss J Econ Stat. 2008;144:337–58. Bilger M, Chaze J-P. What drives individual health expenditure in Switzerland? Swiss J Econ Stat. 2008;144:337–58.
4.
go back to reference Chaze J-P. Assessing household health expenditure with Box-Cox censoring models. Health Econ. 2005;14:893–907.CrossRefPubMed Chaze J-P. Assessing household health expenditure with Box-Cox censoring models. Health Econ. 2005;14:893–907.CrossRefPubMed
5.
go back to reference Norton EC, Wang H, Stearns SC. Out-of-pocket health care expenditures. Swiss J Econ Stat. 2006;142:3–11. Norton EC, Wang H, Stearns SC. Out-of-pocket health care expenditures. Swiss J Econ Stat. 2006;142:3–11.
6.
go back to reference Jones G, Savage E, Van Gool K. The distribution of household health expenditures in Australia. Econ Rec. 2008;84:S99–114.CrossRef Jones G, Savage E, Van Gool K. The distribution of household health expenditures in Australia. Econ Rec. 2008;84:S99–114.CrossRef
7.
go back to reference Jowett M, Contoyannis P, Vinh ND. The impact of public voluntary health insurance on private health expenditures in Vietnam. Soc Sci Med. 2003;56:333–42.CrossRefPubMed Jowett M, Contoyannis P, Vinh ND. The impact of public voluntary health insurance on private health expenditures in Vietnam. Soc Sci Med. 2003;56:333–42.CrossRefPubMed
8.
go back to reference Matsaganis M, Mitrakos T, Tsakloglou P. Modelling health expenditure at the household level in Greece. Eur J Health Econ. 2009;10:329–36.CrossRefPubMed Matsaganis M, Mitrakos T, Tsakloglou P. Modelling health expenditure at the household level in Greece. Eur J Health Econ. 2009;10:329–36.CrossRefPubMed
9.
go back to reference Leibowitz A, Manning WG, Newhouse JP. The demand for prescription drugs as a function of cost-sharing. Soc Sci Med. 1985;21:1063–9.CrossRefPubMed Leibowitz A, Manning WG, Newhouse JP. The demand for prescription drugs as a function of cost-sharing. Soc Sci Med. 1985;21:1063–9.CrossRefPubMed
10.
go back to reference Choi MK. The impact of Medicaid insurance coverage on dental service use. J Health Econ. 2011;30:1020–31.CrossRefPubMed Choi MK. The impact of Medicaid insurance coverage on dental service use. J Health Econ. 2011;30:1020–31.CrossRefPubMed
11.
go back to reference Groenewegen P, Postma J. The supply and utilization of dental services. Soc Sci Med. 1984;19:451–9.CrossRefPubMed Groenewegen P, Postma J. The supply and utilization of dental services. Soc Sci Med. 1984;19:451–9.CrossRefPubMed
12.
go back to reference Holtmann AG, Olsen Jr EO. The demand for dental care: a study of consumption and household production. J Hum Resour. 1976;11:546–60.CrossRefPubMed Holtmann AG, Olsen Jr EO. The demand for dental care: a study of consumption and household production. J Hum Resour. 1976;11:546–60.CrossRefPubMed
13.
go back to reference Manning Jr WG, Phelps CE. The demand for dental care. Bell J of Econ. 1979;10:503–25.CrossRef Manning Jr WG, Phelps CE. The demand for dental care. Bell J of Econ. 1979;10:503–25.CrossRef
14.
go back to reference Nguyen L, Häkkinen U. Choices and utilization in dental care. Eur J of Health Econ. 2006;7:99–106.CrossRef Nguyen L, Häkkinen U. Choices and utilization in dental care. Eur J of Health Econ. 2006;7:99–106.CrossRef
15.
go back to reference Vargas CM, Manski RJ. Dental expenditures and source of payment by race/ethnicity and other sociodemographic characteristics. J Public Health Dent. 1999;59:33–8.CrossRefPubMed Vargas CM, Manski RJ. Dental expenditures and source of payment by race/ethnicity and other sociodemographic characteristics. J Public Health Dent. 1999;59:33–8.CrossRefPubMed
16.
go back to reference White BA. Factors influencing demand for dental services: population, demographics, disease, insurance. J Dent Educ. 2012;76:996–1007.PubMed White BA. Factors influencing demand for dental services: population, demographics, disease, insurance. J Dent Educ. 2012;76:996–1007.PubMed
17.
go back to reference Buntin MB, Zaslavsky AM. Too much ado about two-part models and transformation? Comparing methods of modeling Medicare expenditures. J Health Econ. 2004;23:525–42.CrossRefPubMed Buntin MB, Zaslavsky AM. Too much ado about two-part models and transformation? Comparing methods of modeling Medicare expenditures. J Health Econ. 2004;23:525–42.CrossRefPubMed
18.
go back to reference Deb P, Holmes AM. Estimates of use and costs of behavioural health care: a comparison of standard and finite mixture models. Health Econ. 2000;9:475–89.CrossRefPubMed Deb P, Holmes AM. Estimates of use and costs of behavioural health care: a comparison of standard and finite mixture models. Health Econ. 2000;9:475–89.CrossRefPubMed
19.
go back to reference Deb P, Trivedi PK. The structure of demand for health care: latent class versus two-part models. J Health Econ. 2002;21:601–25.CrossRefPubMed Deb P, Trivedi PK. The structure of demand for health care: latent class versus two-part models. J Health Econ. 2002;21:601–25.CrossRefPubMed
20.
go back to reference Gerdtham UG. Equity in health care utilization: further tests based on hurdle models and Swedish micro data. Health Econ. 1997;6:303–19.CrossRefPubMed Gerdtham UG. Equity in health care utilization: further tests based on hurdle models and Swedish micro data. Health Econ. 1997;6:303–19.CrossRefPubMed
21.
go back to reference Jones AM. Health econometrics. In: Culyer AJ, Newhouse JP, editors. Handbook of health economics. 1st ed. Amsterdam: Elsevier; 2000. p. 265–344. Jones AM. Health econometrics. In: Culyer AJ, Newhouse JP, editors. Handbook of health economics. 1st ed. Amsterdam: Elsevier; 2000. p. 265–344.
22.
go back to reference Pohlmeier W, Ulrich V. An econometric model of the two-part decision making process in the demand for health care. J Human Resour. 1995;30(2):339–61.CrossRef Pohlmeier W, Ulrich V. An econometric model of the two-part decision making process in the demand for health care. J Human Resour. 1995;30(2):339–61.CrossRef
23.
go back to reference Santos Silva J, Windmeijer F. Two-part multiple spell models for health care demand. J Econometrics. 2001;104:67–89.CrossRef Santos Silva J, Windmeijer F. Two-part multiple spell models for health care demand. J Econometrics. 2001;104:67–89.CrossRef
24.
go back to reference Stoddart GL, Barer ML. Analysis of demand and utilization through episodes of medical service. In: van der Gaag J, Perlman M, editors. Health economics. Amsterdam: North-Holland; 1981. p. 149–70. Stoddart GL, Barer ML. Analysis of demand and utilization through episodes of medical service. In: van der Gaag J, Perlman M, editors. Health economics. Amsterdam: North-Holland; 1981. p. 149–70.
25.
go back to reference Grossman M. On the concept of health capital and the demand for health. J Polit Econ. 1972;80:223–55.CrossRef Grossman M. On the concept of health capital and the demand for health. J Polit Econ. 1972;80:223–55.CrossRef
26.
go back to reference Wagstaff A. The demand for health: an empirical reformulation of the Grossman model. Health Econ. 1993;2:189–98.CrossRefPubMed Wagstaff A. The demand for health: an empirical reformulation of the Grossman model. Health Econ. 1993;2:189–98.CrossRefPubMed
27.
go back to reference Manning WG, Mullahy J. Estimating log models: to transform or not to transform? J Health Econ. 2001;20:461–94.CrossRefPubMed Manning WG, Mullahy J. Estimating log models: to transform or not to transform? J Health Econ. 2001;20:461–94.CrossRefPubMed
Metadata
Title
Out-of-pocket expenditure by private households for dental services – empirical evidence from Austria
Authors
Alice Sanwald
Engelbert Theurl
Publication date
01-12-2016
Publisher
Springer Berlin Heidelberg
Published in
Health Economics Review / Issue 1/2016
Electronic ISSN: 2191-1991
DOI
https://doi.org/10.1186/s13561-016-0087-5

Other articles of this Issue 1/2016

Health Economics Review 1/2016 Go to the issue