Lavaste Konsta
Finnish Institute for Health and Welfare, PO Box 30, 00271, Helsinki, Finland.
University of Jyväskylä, PO Box 35, 40014, Jyväskylä, Finland.
Health Econ Rev. 2025 Jan 28;15(1):4. doi: 10.1186/s13561-025-00592-0.
Healthcare expenditures have risen in middle- and high-income countries. One of the potential contributors is the overuse of diagnostics. I explore whether medical imaging is overused when privately owned clinics in Finland treat patients with voluntary private health insurance (VPHI).
I employ administrative insurance claims data from a major Finnish insurance company, covering 2016-2019, and exploit two market entries of clinics owned by the company in 2017. The underlying assumption is that the insurance company's own clinics had weaker incentives to overuse imaging than other privately owned clinics because the payer and the provider belonged to the same entity. I identify the overuse using the staggered difference-in-differences (DID) strategy, in which I consider patients from cities with a market entry as the treatment group and compare them to patients in other similar cities.
I find that the market entries decreased the use of radiography and ultrasound imaging in the treatment of VPHI policyholders, suggesting that private clinics overused these imaging technologies. The more expensive computed tomography (CT) and magnetic resonance imaging (MRI) were, however, not overused.
The results show that private clinics in Finland overused some imaging technologies when treating VPHI policyholders. The extent and magnitude of overuse can, however, vary considerably between imaging technologies and medical ailments.
中高收入国家的医疗保健支出有所增加。其中一个潜在因素是诊断的过度使用。我探讨了芬兰的私立诊所为自愿购买私人健康保险（VPHI）的患者提供治疗时，医学影像是否存在过度使用的情况。
我使用了一家大型芬兰保险公司2016 - 2019年的行政保险理赔数据，并利用了该公司在2017年开设的两家诊所。基本假设是，保险公司自己的诊所相比其他私立诊所，过度使用影像的动机较弱，因为付款方和提供方属于同一实体。我采用交错差分法（DID）策略来确定过度使用情况，即将有诊所开业的城市中的患者作为治疗组，并与其他类似城市的患者进行比较。
我发现诊所开业后，VPHI投保人在治疗中使用X光和超声影像的情况减少，这表明私立诊所过度使用了这些影像技术。然而，更昂贵的计算机断层扫描（CT）和磁共振成像（MRI）并未被过度使用。
结果表明，芬兰的私立诊所在为VPHI投保人提供治疗时过度使用了一些影像技术。然而，过度使用的程度和规模在不同的影像技术和疾病之间可能有很大差异。
