Kiil Astrid, Arendt Jacob Nielsen
KORA, the Danish Institute for Local and Regional Government Research, Købmagergade 22, 1150, Copenhagen K, Denmark.
Int J Health Econ Manag. 2017 Mar;17(1):1-27. doi: 10.1007/s10754-016-9195-3. Epub 2016 Aug 31.
This study estimates the effect of complementary private health insurance (PHI) on the use of health care. The empirical analysis focuses on an institutional setting in which empirical findings are still limited; namely on PHI covering co-payment for treatments that are only partly financed by a universal health care system. The analysis is based on Danish data recently collected specifically for this purpose, which makes identification strategies assuming selection on observables only, and on both observables and unobservables also, both plausible and possible. We find evidence of a substantial positive and significant effect of complementary PHI on the use of prescription medicine and chiropractic care, a smaller but significant effect on dental care, weaker indications of effects for physiotherapy and general practice, and finally that the use of hospital-based outpatient care is largely unaffected. This implies that complementary PHI is generally not simply a marker of a higher propensity to use health care but induces additional use of some health care services over and above what would be used in the absence of such coverage.
本研究估计了补充性私人医疗保险（PHI）对医疗保健使用的影响。实证分析聚焦于一个实证研究结果仍较为有限的制度背景；即针对仅由全民医疗保健系统部分资助的治疗的共付费用提供保险的私人医疗保险。该分析基于近期专门为此目的收集的丹麦数据，这使得仅基于可观测因素以及同时基于可观测和不可观测因素的识别策略，既合理又可行。我们发现有证据表明，补充性私人医疗保险对处方药和脊椎按摩治疗的使用有显著的正向且显著的影响，对牙科护理有较小但显著的影响，对物理治疗和全科医疗的影响迹象较弱，最后，基于医院的门诊护理的使用在很大程度上未受影响。这意味着补充性私人医疗保险通常不仅仅是使用医疗保健倾向较高的一个标志，而是会促使人们额外使用一些医疗保健服务，超出在没有此类保险覆盖情况下的使用量。
