Socioeconomic and Health Determinants of Health Care Utilization Among Elderly Europeans: A Semiparametric Assessment of Equity, Intensity and Responsiveness for Ten European Countries

This paper investigates the interplay of socioeconomic and medical determinants of health care utilization among elderly Europeans from ten countries. Using novel strictly comparable cross-national data from the Survey of Health, Ageing and Retirement in Europe (SHARE), the study exploits recent semi- and nonparametric estimation methods to illustrate how individual socioeconomic status and health determine health care utilization in different institutional settings. Our flexible estimation method allows for the use of multiple health measures to adjust for individual differences in health care need without sacrificing cross-national comparability of the resulting estimates. Within countries, we find only a small, if any, socioeconomic gradient. Moreover, all health systems appear to be reasonably responsive to differences in care need. At the same time, we find considerable variation in treatment intensity across countries, which we cannot fully explain by differences in health care need.