The Palestinian Economy. Theoretical and Practical Challenges

Proceedings “The Palestinian Economy: Theoretical and Practical Challenges” 367
relative fractional rank (R i ) is thus computed as: C y = 2 / yi
covw(
yi
,Ri
)– where cov w
represents the weighted covariance (Lerman and Yitzhaki 1989). In addition, we also
separately investigate primary-level (outpatient-clinic) and secondary-level (hospitalinpatient
admissions) by type of health care sectors\providers: Public, Private, and NGOs.
This is done by deriving a probability-based outcome of any use during the reference
period. Simple quintile distributions and CI’s based on the actual probability of use for
each level of care and care providers are thus computed.
Lastly, statistical significance of observed variation in the computed values of each
of the above contribution terms of decomposition were tested using bootstrap (BTS)
method (Efron and Tibshirani 1993). For the case of a complex multi-stage sampling
design such as the one we deal with in this essay, the appropriate bootstrap procedure
involves, first, randomly drawing, with replacement, a large number (R) of random subsamples
of size n – with n equal to the original sample size – out of the original dataset –
the so-called BTS re-samples. For each BTS re-sample, the sampling weights are
normalised to a mean of one, and then the entire (weighted) procedure are applied to
obtain the factor contributions, including the regressions, fractional rank construction and
covariance computations. The procedure is replicated to the generated BTS re-samples,
yielding for each of them the contributions estimates – BTS replications. Lastly, by using
these datasets, an estimate of the standard error of each factor’s contribution and for the
HI index can be computed (cf., e.g. Abu-Zaineh, Mataria et al. 2008).
4. Results
The results are presented in sub-Sections 4.1 and 4.2. The first presents simple
(unstandardised) quintile distributions and estimates of concentration indices (CI’s) for
the (actual) probability of use for each level of care and care providers; and the second
presents the decomposition results based on microsimulation method proposed above.
4.1. Quintile Distribution of Health Care Utilisation and Income-Related
Inequality Indices for the Probability of a Visit/Use
The level of health care utilisation in both regions of the OPT, the WB and GS, are quite
high: the proportions of individuals who have sought for a primary-level treatment