The effect of insurance on emergency room visits: An analysis of the 2006 Massachusetts health reform
The effect of insurance on emergency room visits: An analysis of the 2006 Massachusetts health reform
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DOI：
10.1016/j.jpubeco.2012.07.004
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发表时间：
2012-12-01
影响因子：
9.8
通讯作者：
Miller, Sarah
中科院分区：
文献类型：
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作者：
Miller, Sarah
本文分析了马萨诸塞州重大医疗改革对急诊室（ER）访问量的影响。我利用改革前各县不保险率的变化来确定改革对急诊室就诊的因果影响。我的估计表明，改革将急诊室的使用率降低了5%至8%，几乎所有这些都是由于可以在其他环境中治疗的非紧急访问的减少。在医生办公室可能开放的正常办公时间，急诊室就诊的减少最为明显。相比之下，我发现对心脏病发作等不可预防的紧急情况没有效果。这些估计与保险对急诊就诊的巨大因果效应相一致，并意味着扩大保险覆盖范围可能对卫生服务的效率产生重大影响。(C) 2012 Elsevier B.V.版权所有
This paper analyzes the impact of a major health reform in Massachusetts on emergency room (ER) visits. I exploit the variation in pre-reform uninsurance rates across counties to identify the causal effect of the reform on ER visits. My estimates imply that the reform reduced ER usage by between 5 and 8%, nearly all of which is accounted for by a reduction in non-urgent visits that could be treated in alternative settings. The reduction in emergency room visits is most pronounced during regular office hours when physician's offices are likely to be open. In contrast, I find no effect for non-preventable emergencies such as heart attacks. These estimates are consistent with a large causal effect of insurance on ER visits and imply that expanding insurance coverage could have a substantial impact on the efficiency of health services. (C) 2012 Elsevier B.V. All rights reserved.