Aakvik Arild, Holmås Tor Helge, Kjerstad Egil
Department of Economics, University of Bergen, Fosswinckelsg 6, N-5007 Bergen, Norway.
J Health Econ. 2003 Sep;22(5):747-62. doi: 10.1016/S0167-6296(03)00025-0.
This paper estimates treatment effects for back pain patients using observational data from a low-key social insurance reform in Norway. Using a latent variable model, we estimate the average treatment effect (ATE), the average effect of treatment on the treated (TT), and the distribution of treatment effects for multidisciplinary outpatient treatment at three different locations. To estimate these treatment effects, we use a discrete-choice model with unobservables generated by a factor structure model. Distance to the nearest hospital (in kilometres) is used as an instrument in estimating the different treatment effects. We find a positive effect of treatment of around 6 percentage points on the probability of leaving the sickness benefits scheme after allowing for selection effects and full heterogeneity in treatment effects. We also find that there are sound arguments for expanding the multidisciplinary outpatient programme for treating back pain patients.
本文利用挪威一项低调的社会保险改革的观测数据,估计背痛患者的治疗效果。通过一个潜在变量模型,我们估计了平均治疗效果(ATE)、治疗对治疗对象的平均效果(TT),以及在三个不同地点进行多学科门诊治疗的治疗效果分布。为了估计这些治疗效果,我们使用了一个离散选择模型,其中不可观测因素由一个因子结构模型生成。到最近医院的距离(以公里为单位)被用作估计不同治疗效果的工具。在考虑了选择效应和治疗效果的完全异质性后,我们发现治疗对离开疾病补贴计划的概率有大约6个百分点的积极影响。我们还发现,有充分的理由扩大治疗背痛患者的多学科门诊项目。