Alexander Labeit, Department of Health Sciences, University of Leicester, UK
dynamic panel data models, prevention, health check-ups
Individuals have the possibility to visit different health check-ups within the NHS in UK: breast cancer screening, cervical cancer screening, blood pressure check, cholesterol test, dental screening and eyesight test. My analysis uses the BHPS covering the period from 1992 to 2008 and investigates empirically how individual and household characteristics, past screening behaviour and policy changes affect the uptake of any of these specific NHS health check-ups. For the conceptual framework, I use a human capital approach (Grossman model) which is extended for non-economic factors.
Independent variables in the equation estimations are lagged dependent variables up to lag 3, equivalised household income, age, gender and partner status, number and age of children, ethnicity, employment, education level, self-rated health status, health problems, smoking, region and moved residence within UK and race. I estimate unbalanced and balanced versions of dynamic panel data models of binary choice for the different health check-ups and use as econometric method dynamic RE probit models with initial conditions (Mundlak-Wooldridge). Also marginal effects for these models are estimated and for considering the influence of attrition effects for the estimation inverse probability weighted models (IPW) are used.
Results with dynamic RE probit models (Mundlak-Wooldridge specification) show that in accordance with expectations previous health check-ups one year before (first lag) and higher lags which correspond to the recommended interval for the specific health check-up have the expected positive effect on uptake. Age has for all of the check-ups a nonlinear relationship and the effects of variables such as living with a partner, education, ethnicity, health status and smoking differ for the different health check-ups. For policy changes only the coefficient for breast cancer screening has the expected sign, however not for cervical and dental screening. A higher permanent income leads to a higher uptake for dental screening, however not for all other health check-ups.