THE DYNAMICS OF MEDICAL CARE USE IN THE BRITISH HOUSEHOLD PANEL SURVEY
利用18波英国家庭面板调查数据，研究发现即使在控制健康状况后，医疗护理使用仍存在显著持续性，尤其是“不使用”和“高使用”状态，且女性、健康状况差及老年人中持续性更强。不可观测异质性解释了10%-25%的变异，这对医疗需求计量建模及健康改善政策的有效性评估有启示。
We explore whether medical care use is persistent over a long panel using 18 waves of the British Household Panel Survey. Of particular interest is high medical care use because a few high users account for a disproportionate amount of use while many individuals use no medical care in a given year. If health is a primary driver of medical care demand, and we control for health, then past medical care use should be uninformative for future use. However, we find that conditional on health, other covariates and unobservable heterogeneity, medical care use remains significantly persistent. "No use" and "high use" are more strongly persistent, and persistence is generally stronger for women, those in poor health, and at older ages. We find that unobservable heterogeneity explains between 10% and 25% of the variation in medical care use. This heterogeneity is significantly correlated with both medical care use and health over our long panel. These findings have implications for the econometric modeling of medical care demand and suggest that policies aimed to reduce aggregate medical care spending by improving health, particularly the health of seniors, may be less effective than projected using static models.