Gerfin Michael, Schellhorn Martin
Department of Economics, Universität Bern, Switzerland.
Health Econ. 2006 Sep;15(9):1011-20. doi: 10.1002/hec.1113.
We evaluate the effect of the size of deductibles in the basic health insurance in Switzerland on the probability of a doctor visit. We employ nonparametric bounding techniques to minimise statistical assumptions. In order to tighten the bounds we consider two further assumptions: mean independence of an instrument and monotone treatment response. Under these two assumption we are able to bound the causal effect of high deductibles compared to low deductibles below zero. We conclude that the difference in health care utilisation is partly due to a reduction of moral hazard effects.
我们评估了瑞士基本医疗保险中免赔额大小对看医生概率的影响。我们采用非参数界定技术来尽量减少统计假设。为了收紧界定范围,我们考虑另外两个假设:工具变量的均值独立性和单调治疗反应。在这两个假设下,我们能够将高免赔额与低免赔额相比的因果效应界定在零以下。我们得出结论,医疗保健利用率的差异部分归因于道德风险效应的降低。