Center for Environmental and Resource Economics and Policy, North Carolina State University, Raleigh, NC 27695-8109, USA.
Health Econ. 2012 Aug;21(8):883-901. doi: 10.1002/hec.1756. Epub 2011 Jun 6.
We use invoices for hospital services from a regional hospital in Croatia to test for adverse selection and moral hazard. There are three categories of patients: with no supplemental insurance, who bought it, and who are entitled to it for free. Our identification procedure relies on the premise that the difference in the observed medical care consumption between the patients who bought the insurance and those entitled to free insurance is caused by pure selection effect, whereas the difference in healthcare consumption between the group that received the free insurance and the group that has no insurance is due to moral hazard. Results show favorable selection for patients in 20- to 30-year-old cohort and significant moral hazard for all age cohorts. The selection effect reverses its sign in older cohorts explained by the differences in risk aversion across cohorts caused by the timing of transition from socialism to market economy.
我们使用克罗地亚一家地区医院的住院服务发票来检验逆向选择和道德风险。有三种类型的患者：没有补充保险、购买保险和免费获得保险的人。我们的识别程序依赖于这样一个前提，即购买保险的患者和免费保险的患者之间观察到的医疗保健消费差异是由纯粹的选择效应引起的，而接受免费保险的患者和没有保险的患者之间的医疗保健消费差异是由于道德风险。结果表明，20 至 30 岁年龄组的患者存在有利选择，所有年龄组都存在显著的道德风险。选择效应在年龄较大的群体中反转，这是由从社会主义向市场经济过渡的时间导致的不同风险偏好造成的。
