An econometric model of health care demand with nonlinear pricing

Johannes S. Kunz, Rainer Winkelmann

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2 Citations (Scopus)


From 2004 to 2012, the German social health insurance levied a co-payment for the first doctor visit in a calendar quarter. We develop a new model for estimating the effect of such a co-payment on the individual number of visits per quarter. The model combines a one-time increase in the otherwise constant hazard rate determining the timing of doctor visits with a difference-in-differences strategy to identify the reform effect. An extended version of the model accounts for a mismatch between reporting period and calendar quarter. Using data from the German Socio-Economic Panel, we do not find an effect of the co-payment on demand for doctor visits.

Original languageEnglish
Pages (from-to)691-702
Number of pages12
JournalHealth Economics
Issue number6
Publication statusPublished - Jun 2017
Externally publishedYes


  • co-payment
  • count data
  • hurdle model
  • Poisson process

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