Patient payments and the empirical analysis of consumer demand for hospital services: an application for Bulgaria

• Published in: Society and economy 2012-06, Vol.34 (2), p.313-338
• Main Authors: Atanasova, Elka, Pavlova, Milena, Moutafova, Emanuela, Kostadinova, Todorka, Groot, Wim
• Format: Article
• Language: English
• Subjects: Consumer behavior; Consumers; Consumption; Datasets; Demand; Demand analysis; Dependent variables; Economic models; Fees & charges; Health and medicine and law; Health care economics; Health care industry; Health care payments; Health economics; Health services; Hospitalization; Hospitals; Life sciences; Low income groups; Management and complex organizations; Minimum wage; Modeling; National Economy; Parametric models; Patients; Payment models; Payments; Preferences; Public health; Socio-Economic Research; Studies; Validity; Willingness to pay
• ISSN: 1588-9726; 1588-970X
• DOI: 10.1556/SocEc.34.2012.2.8

The implementation or amendment of patient charges in a country could benefit from preliminary analyses of their potential effects on health care demand. This paper focuses on hospital care. The paper aims to identify strategies for the empirical analysis of the demand for hospital services that are useful for the assessment of patient charges in the hospital sector, and to compare these strategies using empirical data for Bulgaria. The data were collected in 2010 in a representative survey among consumers. We apply both revealed- and stated-preference approaches. Within the framework of revealed preferences, we use data on various types of patient payments (total payments, formal payments and informal payments) as dependent variables to define three empirical models. Within the framework of stated preferences, we use data on stated willingness to pay for a hospitalization for different sub-samples (current users, users and all respondents), which also results in three empirical models. We observe some similarities and differences between the models based on stated-preference data and those based on revealed-preference data. Although our findings need to be studied further to establish how rigorous they are, they can be useful for setting up new studies on the convergent validity of the two approaches.