Cut-Point Shift and Index Shift in Self-Reported Health

25 Pages Posted: 13 Sep 2004

See all articles by Maarten Lindeboom

Maarten Lindeboom

Vrije Universiteit Amsterdam; Tinbergen Institute Amsterdam; IZA Institute of Labor Economics

Eddy van Doorslaer

Erasmus School of Economics

Date Written: September 2004


There is a 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 allows us 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 (HUI) is used as a more objective health measure than the simple 5-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.

Keywords: health measurement, ordered response models, cut point shift, index shift, Canada

JEL Classification: D30, D31, I10, I12

Suggested Citation

Lindeboom, Maarten and van Doorslaer, Eddy, Cut-Point Shift and Index Shift in Self-Reported Health (September 2004). Available at SSRN:

Maarten Lindeboom (Contact Author)

Vrije Universiteit Amsterdam ( email )

De Boelelaan 1105
1081 HV Amsterdam
+31 20 444 6033 (Phone)
+31 20 444 6020 (Fax)

Tinbergen Institute Amsterdam

Gustav Mahlerplein 117
Amsterdam, 1082 MS

IZA Institute of Labor Economics

P.O. Box 7240
Bonn, D-53072

Eddy Van Doorslaer

Erasmus School of Economics ( email )


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