Department of Economics, University of Wisconsin-Madison, Madison, Wisconsin, USA.
Health Econ. 2021 Jun;30(6):1259-1275. doi: 10.1002/hec.4244. Epub 2021 Mar 17.
This paper measures consumer responsiveness to cost sharing in healthcare using a regression discontinuity design. I use a novel and detailed claims-level dataset from the Colombian healthcare market, where the government exogenously determines a tier system for coinsurance rates and copays based on the enrollee's monthly income. I find that patients exposed to higher coinsurance rates demand fewer services relative to patients facing lower cost sharing. This reduction holds for both discretionary and preventive services. Lower utilization translates into lower costs, despite evidence that patients facing higher prices do not substitute away from more expensive providers.
本文使用回归间断设计来衡量医疗保健成本分担对消费者的反应。我使用了来自哥伦比亚医疗市场的新颖而详细的索赔级数据集，政府根据参保人的月收入人为确定共付额和自付额的等级制度。我发现，与面临较低成本分担的患者相比，面临较高共付额率的患者对服务的需求减少。这种减少既适用于任意服务，也适用于预防服务。尽管有证据表明，面对更高价格的患者不会从更昂贵的提供者那里转移，但较低的利用率转化为较低的成本。
