Astrid Kiil

In both basic research and applied domains, the prevailing paradigm for assessing social development has shifted from deficit-oriented measures to strength-based assessments or a combination. However, it is not yet clear the extent to which strength-based assessment reflects one end of a single dimension of children’s socio-emotional skills, or a distinctly different dimension from a problem-focused examination. This validation study compares the Social Emotional Assessment Measure (SEAM) with two well-known psychopathological questionnaires (the Caregiver-Teacher Report Form; C-TRF and the Strengths and Difficulties Questionnaire; SDQ-T. We explore the relations between and the variation of the three questionnaires’ scores based on a low-risk sample of 2−5-year-old Danish children (n = 291). The SEAM Empathy Index is directly and positively related to the SDQ-T Prosocial subscale, while the SEAM Self-regulation & Cooperation Index is directly and negatively related to the SDQ-T Conduct problems subscale and the C-TRF Aggressive behaviour and Attention problems subscales. The variation in the SEAM indexes at the floor of the problem-based scales appears to reflect that strength-based assessments measure a distinct aspect of behaviour that is not identical to absence of problem-based behaviour. Thus, positive and negative aspects of socio-emotional skills are not entirely on the same dimension, and strength-based assessment improves the range of information. Abbreviations: Child Behavior Checklist: CBCL; Social Emotional Assessment Measure: SEAM; Strengths and Difficulties Questionnaire: SDQ

This study estimates the effect of complementary private health insurance (PHI) on the use of health care. The empirical analysis focuses on an institutional setting in which empirical findings are still limited; namely on PHI covering co-payment for treatments that are only partly financed by a universal health care system. The analysis is based on Danish data recently collected specifically for this purpose, which makes identification strategies assuming selection on observables only, and on both observables and unobservables also, both plausible and possible. We find evidence of a substantial positive and significant effect of complementary PHI on the use of prescription medicine and chiropractic care, a smaller but significant effect on dental care, weaker indications of effects for physiotherapy and general practice, and finally that the use of hospital-based outpatient care is largely unaffected. This implies that complementary PHI is generally not simply a marker of a higher propensity to use health care but induces additional use of some health care services over and above what would be used in the absence of such coverage.

This article reviews the quantitative evidence on the behavioural effects of copayment within the health area across a wide range of countries. The review distinguishes itself from previous similar reviews by having a high degree of transparency for the search strategy used to identify the studies included in the review as well as the criteria for inclusion and by including the most recent literature. Empirical studies were identified by performing searches in EconLit. The literature search identified a total of 47 studies of the behavioural effects of copayment. Considering the demand effects, the majority of the reviewed studies found that copayment reduces the use of prescription medicine, consultations with general practitioners and specialists, and ambulatory care, respectively. The literature found no significant effects of copayment on the prevalence of hospitalisations. The empirical evidence on whether copayment for some services, but not for others, causes substitution from the services that are subject to copayment to the ‘free’ services rather than lower total use is sparse and mixed. Likewise, the health effects of copayment have only been analysed empirically in a limited number of studies, of which half did not find any significant effects in the short term. Finally, the empirical evidence on the distributional consequences of copayment indicates that individuals with low income and in particular need of care generally reduce their use relatively more than the remaining population in consequence of copayment. Hence, it is clear that copayment involves some important economic and political trade-offs.