疫苗接种政策、延迟治疗和医疗支出

Erkmen G Aslim, Wei Fu, Chia-Lun Liu, Erdal Tekin
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摘要

本文评估了 COVID-19 疫苗接种对个人延迟或放弃医疗保健倾向的影响。我们的研究设计利用了各州不同年龄段疫苗接种资格的推出随时间推移而产生的可论证的外生变化,作为个人疫苗接种状况的工具。我们发现,接种 COVID-19 疫苗可将因任何病症而推迟就医的可能性降低 37%。此外,我们的分析还显示,由于父母符合疫苗接种资格,儿童推迟或放弃医疗保健的可能性大大降低,这表明家庭内部存在着积极的健康溢出效应,这种溢出效应超出了保护儿童免受感染的范围。我们的分析还显示,接种疫苗减少了对感染或传播 COVID-19 的担忧,从而增加了流动性,并有可能减少延迟或逃避就医的情况。此外,我们发现接种疫苗明显增加了选择性医疗和手术的机会,但对急诊入院、精神疾病或其他医疗状况没有显著影响。我们的研究结果凸显了疫苗的重要作用,它不仅能预防冠状病毒,还能防止因延误或放弃就医而导致的健康状况恶化。在少数民族和社会经济背景较差的人群中,疫苗接种导致的延误或放弃治疗的减少尤为明显,这揭示了疫苗接种工作在缩小健康和医疗不平等方面的重要作用。在补充分析中,我们利用借记卡和信用卡支出的新数据证明,疫苗接种率的提高在短期内对消费者的医疗保健支出有积极影响,尽管在统计上并不显著。综上所述,我们的研究结果表明,疫苗研发的进步与监管程序的配合,可以在公共卫生危机期间以安全的方式加快向公众提供疫苗,从而解决未得到满足的医疗保健需求。
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Vaccination Policy, Delayed Care, and Health Expenditures
This paper evaluates the effect of COVID-19 vaccination on the individual propensity to delay or skip medical care. Our research design exploits the arguably exogenous variation in age-specific vaccine eligibility rollout across states and over time as an instrument for individual vaccination status. We find that receiving a COVID-19 vaccine reduces the likelihood of delaying care for any medical condition by 37 percent. Furthermore, our analysis reveals that children are significantly less likely to delay or skip healthcare as a result of their parents becoming vaccine eligible, indicating the presence of a positive health spillover within households that extends beyond protection against infection. Our analysis also shows that vaccination reduces concerns about contracting or spreading COVID-19, leading to increased mobility and potentially reducing delays or avoidance in seeking healthcare. Additionally, we find that vaccination notably increased access to elective care and surgeries but had no significant impact on emergency department admissions, mental health cases, or other medical conditions. Our results highlight the important role that vaccines play in, not only protecting against coronavirus, but also safeguarding against the worsening of health due to delayed or foregone medical care. The decline in delayed or foregone care caused by vaccination is particularly strong among minorities and those with a low socioeconomic background, revealing an important role that vaccination efforts can play in narrowing inequities in health and healthcare. In supplementary analysis, we use novel data on debit and credit card spending to demonstrate that increased vaccine uptake has a positive, albeit statistically insignificant, effect on consumer healthcare spending in the short run. Taken together, our findings imply that advancements in vaccine development coupled with a regulatory process that accelerates the availability of vaccines to public in a safe manner can have the additional benefit of tackling unmet healthcare needs during a public health crisis.
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