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流向当地医疗保健支出的回流:来自患者远离家乡时健康冲击的证据。

Returns to Local-Area Healthcare Spending: Evidence from Health Shocks to Patients Far From Home.

作者信息

Doyle Joseph J

机构信息

MIT Sloan School of Management & NBER.

出版信息

Am Econ J Appl Econ. 2011 Jul;3(3):221-243. doi: 10.1257/app.3.3.221.

Abstract

Healthcare spending varies widely across markets, and previous empirical studies find little evidence that higher spending translates into better health outcomes. The main innovation in this paper exploits this cross-sectional variation in hospital spending in a new way by considering patients who are exposed to healthcare systems not designed for them: patients far from home when a health emergency strikes. Visitors to Florida who become ill in high-spending areas have significantly lower mortality rates compared to visitors in lower-spending areas. The results are robust within groups of similar visitors and within groups of destinations that appear to be close demand substitutes-areas that likely attract similar visitors.

摘要

医疗保健支出在不同市场之间差异很大,先前的实证研究几乎没有发现高支出能转化为更好的健康结果的证据。本文的主要创新之处在于,通过考虑那些接触到并非为他们设计的医疗系统的患者,以一种新的方式利用了医院支出的这种横截面差异:即健康紧急情况发生时远离家乡的患者。在高支出地区生病的佛罗里达游客的死亡率明显低于低支出地区的游客。在类似游客群体以及似乎是相近需求替代地的目的地群体(可能吸引类似游客的地区)中,结果都是稳健的。

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本文引用的文献

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Is American health care uniquely inefficient?美国的医疗保健是否特别低效?
J Econ Perspect. 2008 Fall;22(4):27-50. doi: 10.1257/jep.22.4.27.
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The lifetime costs and benefits of medical technology.医疗技术的终身成本与效益。
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Cost effectiveness of adult intensive care in the UK.英国成人重症监护的成本效益。
Anaesthesia. 2007 Jun;62(6):547-54. doi: 10.1111/j.1365-2044.2007.04997.x.
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National health spending in 2005: the slowdown continues.2005年的国家医疗支出:增速放缓仍在持续。
Health Aff (Millwood). 2007 Jan-Feb;26(1):142-53. doi: 10.1377/hlthaff.26.1.142.

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