Goodman A C
Inquiry. 1989 Summer;26(2):235-48.
An offset (substitution) effect occurs when the use of one treatment reduces levels or costs of alternative treatments. This model considers offsets through the demand for health services and the technology for providing them. Mental health offsets in the provision of ambulatory physician care are analyzed by estimating permanent income, health expenditures, and budget shares, in a three stage process, for the categories Mental Health, Chronic, Mixed, Acute, and Other, using the NMCES database. Tobit estimators are used since many observations have zero expenditures. Ambulatory physician care expenditures are relatively elastic with respect to price and to coinsurance, but less elastic with respect to income. Mental health care is a substitute for Chronic and Other, but not for Mixed and Acute.
当一种治疗方法的使用降低了替代治疗方法的水平或成本时,就会产生替代(替换)效应。该模型通过对健康服务的需求和提供这些服务的技术来考虑替代效应。使用NMCES数据库,通过三个阶段的过程估计永久收入、医疗支出和预算份额,对心理健康、慢性疾病、混合疾病、急性疾病和其他类别在门诊医生护理提供中的心理健康替代效应进行分析。由于许多观察值的支出为零,因此使用Tobit估计量。门诊医生护理支出对价格和共同保险相对具有弹性,但对收入的弹性较小。心理健康护理是慢性疾病和其他疾病护理的替代品,但不是混合疾病和急性疾病护理的替代品。