俄勒冈医疗保险实验：第一年的证据
THE OREGON HEALTH INSURANCE EXPERIMENT: EVIDENCE FROM THE FIRST YEAR.
作者信息
Finkelstein Amy, Taubman Sarah, Wright Bill, Bernstein Mira, Gruber Jonathan, Newhouse Joseph P, Allen Heidi, Baicker Katherine
出版信息
Q J Econ. 2012 Aug;127(3):1057-1106. doi: 10.1093/qje/qjs020. Epub 2012 May 3.
Abstract
In 2008, a group of uninsured low-income adults in Oregon was selected by lottery to be given the chance to apply for Medicaid. This lottery provides an opportunity to gauge the effects of expanding access to public health insurance on the health care use, financial strain, and health of low-income adults using a randomized controlled design. In the year after random assignment, the treatment group selected by the lottery was about 25 percentage points more likely to have insurance than the control group that was not selected. We find that in this first year, the treatment group had substantively and statistically significantly higher health care utilization (including primary and preventive care as well as hospitalizations), lower out-of-pocket medical expenditures and medical debt (including fewer bills sent to collection), and better self-reported physical and mental health than the control group.
摘要
2008年，俄勒冈州一群未参保的低收入成年人通过抽签获得了申请医疗补助的机会。这次抽签提供了一个机会，利用随机对照设计来评估扩大公共医疗保险覆盖范围对低收入成年人的医疗保健使用、经济压力和健康状况的影响。在随机分配后的一年里，抽签选中的治疗组拥有保险的可能性比未被选中的对照组高出约25个百分点。我们发现，在第一年，治疗组在医疗保健利用率（包括初级和预防保健以及住院治疗）方面显著高于对照组，且具有统计学意义，自付医疗费用和医疗债务更低（包括被催收的账单更少），自我报告的身心健康状况也比对照组更好。
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