The instrumental variable method to study self-selection mechanism: a case of influenza vaccination

Value in Health : the Journal of the International Society for Pharmacoeconomics and Outcomes Research
Byung-Kwang Yoo, Kevin D Frick

Abstract

To assess whether estimates of the effectiveness of influenza vaccination in reducing rates of hospitalizations and all-cause mortality derived from cross-sectional data could be improved by applying the instrumental variable (IV) method to data representing the community-dwelling elderly population in the United States in order to adjust for self-selection bias. Secondary data analysis, using the 1996-97 Medicare Current Beneficiary Survey data. First, using single-equation probit regressions this study analyzed influenza-related hospitalization and death due to all causes predicted by vaccination status, which was measured by claims or survey data. Second, to adjust for potential self-selection of the vaccine receipt, for example, higher vaccination rates among high-risk individuals, bivariate probit (BVP) models and two-stage least squares (2SLS) models were employed. The IV was having either arthritis or gout. In single-equation probit models, vaccination appeared to be ineffective or even to increase the probability of adverse outcomes. Based on BVP and 2SLS models, vaccination was demonstrated to be effective in reducing influenza-related hospitalization by at least 31%. The BVP model results implied significant self-sele...Continue Reading

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Citations

Oct 5, 2007·The New England Journal of Medicine·John D Treanor
Dec 18, 2010·Journal of Clinical Epidemiology·Yong Chen, Becky A Briesacher
Oct 23, 2010·American Journal of Preventive Medicine·Justin G TrogdonHope F Thompson
Jul 14, 2010·The American Journal of Geriatric Pharmacotherapy·Bruce StuartJason Kemner
Aug 25, 2015·Value in Health : the Journal of the International Society for Pharmacoeconomics and Outcomes Research·Minchul Kim, Byung-Kwang Yoo
Aug 22, 2009·Value in Health : the Journal of the International Society for Pharmacoeconomics and Outcomes Research·Rolf H H GroenwoldArno W Hoes
Feb 16, 2020·European Journal of Public Health·Tom Van Ourti, Nicolas Bouckaert
Jan 26, 2022·PloS One·Yigezu Atnafe YigezuAymen Frija

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