Economic Research Department, Banco de Portugal, Av. Almirante Reis 71 6, Lisbon, Portugal.
Health Econ. 2010 Sep;19(9):1075-92. doi: 10.1002/hec.1641.
Double health insurance coverage exists when an individual benefits from more than one health insurance plan at the same time. We examine the impact of such supplementary insurance on the utilisation of doctor consultations in Portugal, taking advantage of institutional features which make double coverage plausibly exogenous. The novelty is that the analysis is carried out for different points of the conditional distribution, not only for its mean location, within the context of count data modelling and without imposing restrictive parametric assumptions.Results indicate that double coverage creates additional utilisation of health care across the whole outcome distribution for both public and private second layers of health insurance coverage but with greater magnitude in the latter group. We unveil that this additional consumption effect is relatively smaller for more frequent users.
当个人同时受益于多种医疗保险计划时,就存在双重健康保险覆盖。我们利用制度特征,使补充保险具有外生性,从而检验了这种补充保险对葡萄牙医生就诊利用的影响。新颖之处在于,我们在不施加限制性参数假设的情况下,在计数数据建模的背景下,针对条件分布的不同点进行分析,而不仅仅是针对均值位置。结果表明,双重覆盖在公共和私人第二层医疗保险覆盖的整个结果分布中都产生了额外的医疗保健利用,但在后一组中,这种影响的程度更大。我们揭示了这种额外的消费效应对于更频繁的使用者来说相对较小。