Pekola Piia, Linnosmaa Ismo, Mikkola Hennamari
Social Insurance Institution of Finland, PL 450, 00056, Helsinki, Finland.
National Institute for Health and Welfare, PL 30, 00271, Helsinki, Finland.
Health Econ Rev. 2017 Dec;7(1):25. doi: 10.1186/s13561-017-0158-2. Epub 2017 Jun 23.
In health care, many aspects of the delivery of services are subject to regulation. Often the purpose of the regulated health care system is to encourage providers to keep costs down without skimping on quality. The purpose of this paper is to analyse the effect of price regulation and free choice on quality in physiotherapy organised by the Social Insurance Institution of Finland for the disabled individuals.We use the difference-in-differences method in our effort to isolate the effect of the regulation and for this task we have defined the regulated and non-regulated firms and their quality before and after the regulation. The variables needed in the econometric modelling were collected from several registers as well as by carrying out questionnaires on the firms.We show that price regulation decreased quality in physiotherapy statistically significantly and the mechanism was unable to incentivise firms to invest in quality. Most likely, our results are caused by cost reduction associated with price regulation. It seems that cost reduction was carried out through quality reductions in physiotherapy instead of increasing productivity. The result is sensible because comparable quality information is not published to support patient choice in this sector.
在医疗保健领域，服务提供的许多方面都受到监管。通常，受监管的医疗保健系统的目的是鼓励提供者在不降低质量的情况下降低成本。本文的目的是分析芬兰社会保险机构为残疾人士组织的物理治疗中价格监管和自由选择对质量的影响。我们使用差异中的差异方法来努力分离监管的影响，为此我们定义了受监管和不受监管的公司及其在监管前后的质量。计量经济学建模所需的变量是从几个登记册收集的，也通过对公司进行问卷调查收集。我们表明，价格监管在统计学上显著降低了物理治疗的质量，并且该机制无法激励公司投资于质量。最有可能的是，我们的结果是由与价格监管相关的成本降低导致的。似乎成本降低是通过降低物理治疗的质量而不是提高生产率来实现的。这个结果是合理的，因为在这个部门没有公布可比的质量信息来支持患者选择。
