Keeler E B, Rolph J E
J Health Econ. 1988 Dec;7(4):337-67. doi: 10.1016/0167-6296(88)90020-3.
This paper analyzes claims data from the RAND Insurance Experiment, which were grouped into episodes of treatment. The insurance plans in the experiment have coinsurance and a cap on out-of-pocket spending. Using new statistical techniques to adjust for the increased sickliness of those who exceed the cap, the effects of coinsurance on cost per episode and number of episodes are estimated. Cost sharing reduced the number of episodes but had little effect on cost per episode. People in the experiment responded myopically as their current insurance status changed through the year. The price elasticity of spending was about -0.2 throughout the range of coinsurance studied. When data permit it, the study of episodes complements analyses of annual medical spending by revealing more about how decisions to spend are made within the year.
本文分析了兰德保险实验的理赔数据，这些数据被分组为治疗阶段。实验中的保险计划设有共保条款和自付费用上限。运用新的统计技术对超出上限者病情加重的情况进行调整后，估算了共保对每个治疗阶段成本及治疗阶段数量的影响。费用分摊减少了治疗阶段数量，但对每个治疗阶段的成本影响不大。随着全年当前保险状态的变化，实验中的人们反应短视。在所研究的共保范围内，支出的价格弹性约为-0.2。当数据允许时，对治疗阶段的研究通过更深入揭示全年内的支出决策方式，补充了对年度医疗支出的分析。
