没有保险的人需要更少的护理吗?马里兰医院的证据

IF 1.5 4区经济学 Q3 BUSINESS, FINANCE International Journal of Health Economics and Management Pub Date : 2020-09-01 Epub Date: 2020-03-06 DOI:10.1007/s10754-020-09280-4

Amanda Cook

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引用次数: 0

摘要

没有保险的个人获得较少的医疗保健服务至少有三个原因:承担全部账单的责任，更高的价格，以及潜在的供应商因担心不付款而减少。我把没有保险的病人通过利用马里兰州高度监管的医疗保健系统来承担全部经济责任时的削减隔离开来。价格由国家制定，对所有病人都是统一的，医院可以得到免费医疗和坏账的补偿。我使用了数据的一个独特特征，即在两次就诊之间获得或失去保险的患者多次再入院，以隔离个人在没有保险缴纳的情况下支付全价时所需数量的减少。布林德-瓦哈卡的一项分解估计，在考虑了病人、疾病和医院特征的差异后，没有保险的人获得的服务比有保险的人少6%。

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Do the uninsured demand less care? Evidence from Maryland's hospitals.

Uninsured individuals receive fewer healthcare services for at least three reasons: responsibility for the entire bill, higher prices, and potential provider reductions for concern of nonpayment. I isolate reductions when uninsured patients are solely financially responsible by capitalizing on Maryland's highly regulated health care system. Prices are set by the state, are uniform across all patients, and hospitals are compensated for free care and bad debt. I use a unique feature of the data, multiple readmissions for patients who gain or lose insurance between visits, to isolate the reductions in quantity demanded when individuals are faced with paying the full price without an insurance contribution. A Blinder-Oaxaca decomposition estimates uninsured individuals receive 6% fewer services after accounting for differences in patient, illness, and hospital characteristics than when these same individuals are insured.

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来源期刊

International Journal of Health Economics and Management Multiple-

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3.60

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期刊介绍： The focus of the International Journal of Health Economics and Management is on health care systems and on the behavior of consumers, patients, and providers of such services. The links among management, public policy, payment, and performance are core topics of the relaunched journal. The demand for health care and its cost remain central concerns. Even as medical innovation allows providers to improve the lives of their patients, questions remain about how to efficiently deliver health care services, how to pay for it, and who should pay for it. These are central questions facing innovators, providers, and payers in the public and private sectors. One key to answering these questions is to understand how people choose among alternative arrangements, either in markets or through the political process. The choices made by healthcare managers concerning the organization and production of that care are also crucial. There is an important connection between the management of a health care system and its economic performance. The primary audience for this journal will be health economists and researchers in health management, along with the larger group of health services researchers. In addition, research and policy analysis reported in the journal should be of interest to health care providers, managers and policymakers, who need to know about the pressures facing insurers and governments, with consequences for regulation and mandates. The editors of the journal encourage submissions that analyze the behavior and interaction of the actors in health care, viz. consumers, providers, insurers, and governments. Preference will be given to contributions that combine theoretical with empirical work, evaluate conflicting findings, present new information, or compare experiences between countries and jurisdictions. In addition to conventional research articles, the journal will include specific subsections for shorter concise research findings and cont ributions to management and policy that provide important descriptive data or arguments about what policies follow from research findings. The composition of the editorial board is designed to cover the range of interest among economics and management researchers.Officially cited as: Int J Health Econ ManagFrom 2001 to 2014 the journal was published as International Journal of Health Care Finance and Economics. (Articles published in Vol. 1-14 officially cited as: Int J Health Care Finance Econ)