Private insurance, selection, and health care use: A Bayesian analysis of a Roy-type model
Private insurance, selection, and health care use: A Bayesian analysis of a Roy-type model
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DOI：
10.1198/073500106000000323
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发表时间：
2006-10-01
影响因子：
3
通讯作者：
Trivedi, Pravin K.
中科院分区：
文献类型：
--
作者：
Deb, Partha;Munkin, Murat K.;Trivedi, Pravin K.
观察到的私人参保者和未参保者之间的医疗利用差异反映了自我选择和保险激励（道德风险）的综合影响。本文提供了一个贝叶斯框架，用于将差异分解为激励和选择部分。使用从医疗支出小组调查中获得的美国成人非医疗保险人口的多年样本来估计私人保险的自我选择对就诊次数的影响。我们使用基于“罗伊模型”的灵活计量经济学框架，并开发了马尔可夫链蒙特卡罗算法。我们估计了治疗效果的分布，并找到了表明选择的有力证据，平均而言，选择占所观察到的就诊差异的 50% 或更多。
Observed differences in medical utilization between the privately insured and uninsured reflect the combined effects of self-selection and insurance incentives (moral hazard). This article provides a Bayesian framework for decomposing the disparity into incentive and selection components. The effect of self-selection in private insurance on the number of doctor visits is estimated using a multiyear sample of the U.S. adult non-Medicare population obtained from the Medical Expenditure Panel Survey. We use a flexible econometric framework based on the "Roy model" and develop a Markov chain Monte Carlo algorithm. We estimate the distribution of treatment effects and find strong evidence indicating selection, which accounts, on average, for 50% or more of the observed disparity in doctor visits.