A Fuzzy Approach to the Measurement of Leakages for North American Health System

CIRPEE Working Paper No. 11-07

27 Pages Posted: 26 Feb 2011

See all articles by Paul Makdissi

Paul Makdissi

University of Ottawa

Myra Yazbeck

McGill University - Epidemiology, Biostatistics, & Occupational Health; Université Laval - Département d'Économique

Hugo Coldeboeuf

University of Ottawa

Date Written: February 24, 2011

Abstract

This paper uses a fuzzy-fuzzy stochastic dominance approach to compare patients’ leakages in the Canadian and the U.S. health care systems. Leakages are defined in terms of individuals who are in bad health and could not have access to health care when needed. To carry his comparison we rely on the assumption that Canada is a strong counter-factual for the U.S. We first develop a class of fuzzy leakages indices and incorporate them in a stochastic dominance framework to derive the dominance criterion. We then use the derived criterion to perform inter-country comparisons on the global level. To provide more insight, we decompose the analysis with respect to gender, ethnicity, income and education. Intra-country comparisons reveal the presence of income based leakage inequalities in both countries yet, gender, ethnic and education based disparities appear to be present in the U.S. only. As for inter-country comparisons, results are in general consistent with the hypothesis that leakages are less important under the Canadian health care system.

Keywords: Health care resources, Fuzzy sets, Leakage

JEL Classification: D63, I18, I19

Suggested Citation

Makdissi, Paul and Yazbeck, Myra and Coldeboeuf, Hugo, A Fuzzy Approach to the Measurement of Leakages for North American Health System (February 24, 2011). CIRPEE Working Paper No. 11-07, Available at SSRN: https://ssrn.com/abstract=1769133 or http://dx.doi.org/10.2139/ssrn.1769133

Paul Makdissi (Contact Author)

University of Ottawa ( email )

2292 Edwin Crescent
Ottawa, Ontario K2C 1H7
Canada

Myra Yazbeck

McGill University - Epidemiology, Biostatistics, & Occupational Health ( email )

845 Sherbrook Street West
Montreal, Quebec H3A 1G5 QC H3A 0G4
Canada

Université Laval - Département d'Économique ( email )

2325 Rue de l'Université
Ste-Foy, Quebec G1K 7P4 G1K 7P4
Canada

Hugo Coldeboeuf

University of Ottawa ( email )

2292 Edwin Crescent
Ottawa, Ontario K2C 1H7
Canada

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