Chan David C, Card David, Taylor Lowell
Stanford University, Department of Veterans Affairs, and NBER.
UC Berkeley and NBER.
Am Econ Rev. 2023 Nov;113(11):3003-3043. doi: 10.1257/aer.20211638.
We study public versus private provision of health care for veterans aged 65 and older who may receive care provided by the US Department of Veterans Affairs (VA) and in private hospitals financed by Medicare. Utilizing the ambulance design of Doyle et al. (2015), we find that the VA reduces 28-day mortality by 46 percent (4.5 percentage points) and that these survival gains are persistent. The VA also reduces 28-day spending by 21 percent and delivers strikingly different reported services relative to private hospitals. We find suggestive evidence of complementarities between continuity of care, health IT, and integrated care.
我们研究了65岁及以上退伍军人的公共与私人医疗保健服务提供情况，这些退伍军人可能接受美国退伍军人事务部（VA）提供的医疗服务，以及由医疗保险资助的私立医院的医疗服务。利用多伊尔等人（2015年）的“救护车”设计，我们发现退伍军人事务部将28天死亡率降低了46%（4.5个百分点），而且这些生存获益是持续的。退伍军人事务部还将28天的支出降低了21%，并且与私立医院相比，提供的报告服务显著不同。我们发现了护理连续性、健康信息技术和综合护理之间互补性的暗示性证据。
