Huțu Daniela, Cumpăt Carmen Marinela, Grădinaru Andreea, Rusu Bogdan
Faculty of Economics and Business Administration, Alexandru Ioan Cuza University, Carol Boulevard, nr. 11, 700506 Iasi, Romania.
Department of Medical Specialties III, "Grigore T. Popa" University of Medicine and Pharmacy, 700115 Iasi, Romania.
Healthcare (Basel). 2024 Dec 12;12(24):2519. doi: 10.3390/healthcare12242519.
BACKGROUND/OBJECTIVES: Moral hazard represents a significant challenge in healthcare systems globally, reflecting the tendency of insured individuals to over-utilize medical services when shielded from the full costs of care.
This paper investigates the dynamics and implications of moral hazard within the Romanian public hospital sector, offering practical recommendations for healthcare policymakers to mitigate the financial risks associated with excessive healthcare utilization and ensure long-term sustainability. To achieve the objectives of this study, a quantitative research approach utilizing vignettes was employed. Vignettes allow for the simulation of real-world decision-making under conditions of insurance coverage, capturing nuanced behaviors that traditional surveys may overlook.
The study examined patient behaviors in the context of moral hazard in public hospitals in Romania, employing a quantitative approach based on vignettes. A total of 303 valid responses were collected. The findings indicate a significant tendency among insured patients, both publicly and privately insured, to opt for more expensive treatments compared to uninsured patients, who preferred more affordable options such as medication or physiotherapy. In the case of treatments for severe conditions, insured patients frequently chose combinations of higher-cost therapies, while uninsured individuals either delayed treatment or opted for less expensive alternatives. These results highlight the impact of moral hazard, driven by a reduced sensitivity to costs in the presence of insurance, and underscore the need for cost-sharing policies to mitigate the overutilization of medical resources.
This paper uniquely contributes to the understanding of moral hazard by integrating insights from both Romanian public hospitals and international case studies, offering practical policy recommendations for mitigating the financial risks associated with excessive healthcare utilization.
背景/目标：道德风险是全球医疗体系面临的一项重大挑战，体现了参保人员在无需承担全部医疗费用时过度使用医疗服务的倾向。
本文研究了罗马尼亚公立医院部门道德风险的动态变化及其影响，为医疗政策制定者提供切实可行的建议，以降低与过度医疗使用相关的财务风险，并确保长期可持续性。为实现本研究的目标，采用了利用情景描述的定量研究方法。情景描述能够模拟在保险覆盖情况下的现实世界决策过程，捕捉传统调查可能忽略的细微行为。
该研究采用基于情景描述的定量方法，考察了罗马尼亚公立医院中道德风险背景下的患者行为。共收集到303份有效回复。研究结果表明，无论是公共保险患者还是私人保险患者，与未参保患者相比，都有显著倾向选择更昂贵的治疗方式，未参保患者更倾向于选择如药物治疗或物理治疗等更经济实惠的选择。在重症治疗方面，参保患者经常选择成本更高的治疗组合，而未参保者要么推迟治疗，要么选择成本较低的替代方案。这些结果凸显了道德风险的影响，这种影响源于保险存在时对成本的敏感度降低，并强调了需要实施成本分担政策以减轻医疗资源的过度使用。
本文通过整合罗马尼亚公立医院和国际案例研究的见解，为理解道德风险做出了独特贡献，为减轻与过度医疗使用相关的财务风险提供了切实可行的政策建议。
