Cut-point shift and index shift in self-reported health

J Health Econ. 2004 Nov;23(6):1083-99. doi: 10.1016/j.jhealeco.2004.01.002.

Abstract

There is some concern that ordered responses on health questions may differ across populations or even across subgroups of a population. This reporting heterogeneity may invalidate group comparisons and measures of health inequality. This paper proposes a test for differential reporting in ordered response models which enables to distinguish between cut-point shift and index shift. The method is illustrated using Canadian National Population Health Survey data. The McMaster Health Utility Index Mark 3 (HUI3) is used as a more objective health measure than the simple five-point scale of self-assessed health. We find clear evidence of index shifting and cut-point shifting for age and gender, but not for income, education or language.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Attitude to Health / ethnology*
  • Canada
  • Culture*
  • Female
  • Health Surveys*
  • Humans
  • Likelihood Functions
  • Logistic Models
  • Male
  • Middle Aged
  • Models, Theoretical
  • Psychometrics
  • Self-Assessment*
  • Socioeconomic Factors