title: Making a distinction between the effect of initial stock and investment in health determinants.
abstract: The objective of this paper was to propose a health production model that distinguishes between the initial stock of health determinants and the subsequent investment in them, with a view to providing information to policy-makers regarding the effects of determinant-aimed policies. In this sense, the main contributions of the paper stem from the development of a theoretical and empirical model that distinguishes between the effect of the initial stock and that of investment in health determinants. To do this, we estimated the health production function using a stochastic frontier model. We present an empirical example using data for the years 2002 and 2008. The results support our decision to analyse the effects of the initial values attributable to health determinants separately from those arising following investment in the period. Concretely, we find significant differences for the determinants EMPLOY, SOCIALCLASS and NON-DRINKER. The results seem to indicate that, for variables labelled with the behavioural aspects of health such as NON-DRINKER, the effect over time of a change in investment in health is significantly greater than that resulting from a variation in initial values. In contrast, for socioeconomic variables such as SOCIAL CLASS or EMPLOY, for which effects on health tend to be more long-term in nature, the opposite occurs, with the effect of the investment during the time period proving significantly lower than the effect of the initial provision.
authors.affiliation: Fundación Investigación Biosanitaria Principado de Asturias (FINBA), Oviedo, Spain.
authors.forename: Esther Lafuente
authors.initials: EL
authors.lastname: Robledo
authors.affiliation: Oviedo Efficiency Group, Universidad de Oviedo, Edificio Departamental de Ciencias Jurídico-Sociales, Avda del Cristo s/n, 33006, Oviedo, Spain. ana@uniovi.es.
authors.forename: Ana
authors.initials: A
authors.lastname: Rodriguez-Alvarez
authors.affiliation: Universidad de Oviedo, Oviedo, Spain.
authors.forename: Andrey Shmarev
authors.initials: AS
authors.lastname: Shmarev
mesh_terms: D064829:Alcohol Abstinence / Q000706:statistics & numerical data*; D004651:Employment / Q000706:statistics & numerical data*; D004777:Environment; D005060:Europe; D015438:Health Behavior; D015276:Health Care Rationing / Q000458:organization & administration; D006297:Health Services Accessibility / Q000458:organization & administration; D054624:Health Status Disparities; D006801:Humans; D008962:Models, Theoretical; D058996:Quality Improvement / Q000458:organization & administration; D012923:Social Class; D064890:Social Determinants of Health / Q000706:statistics & numerical data*; D012959:Socioeconomic Factors
keywords: Health determinants; Self-perceived health; Stochastic health production function frontiers