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受教育程度更高的人会使用更多的医疗服务吗?来自越南的基于回归断点设计的证据。

Do the more educated utilize more health care services? Evidence from Vietnam using a regression discontinuity design.

作者信息

Dang Thang

机构信息

Department of Economics and Related Studies, University of York, York, UK.

School of Economics, University of Economics Ho Chi Minh City (UEH), Ho Chi Minh City, Vietnam.

出版信息

Int J Health Econ Manag. 2018 Sep;18(3):277-299. doi: 10.1007/s10754-018-9233-4. Epub 2018 Jan 10.

Abstract

In 1991, Vietnam implemented a compulsory primary schooling reform that provides this study a natural experiment to estimate the causal effect of education on health care utilization with a regression discontinuity design. This paper finds that education causes statistically significant impacts on health care utilization, although the signs of the impacts change with specific types of health care services examined. In particular, education increases the inpatient utilization of the public health sector, but it reduces the outpatient utilization of both the public and private health sectors. The estimates are strongly robust to various windows of the sample choice. The paper also discovers that the links between education and the probability of health insurance and income play essential roles as potential mechanisms to explain the causal impact of education on health care utilization in Vietnam.

摘要

1991年,越南实施了一项小学义务教育改革,该改革为这项研究提供了一个自然实验,以便通过回归断点设计来估计教育对医疗保健利用的因果效应。本文发现,教育对医疗保健利用产生了具有统计学意义的影响,尽管这些影响的符号会随着所考察的特定医疗保健服务类型而变化。具体而言,教育提高了公共卫生部门的住院利用率,但降低了公共和私营卫生部门的门诊利用率。这些估计结果在各种样本选择窗口下都非常稳健。本文还发现,教育与医疗保险概率和收入之间的联系,作为解释教育对越南医疗保健利用因果影响的潜在机制发挥着重要作用。

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