Patient Cost-Sharing and Hospitalization Offsets in the Elderly
Patient Cost-Sharing and Hospitalization Offsets in the Elderly
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DOI：
10.1257/aer.100.1.193
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发表时间：
2010-03-01
影响因子：
10.7
通讯作者：
McKnight, Robin
中科院分区：
文献类型：
--
作者：
Chandra, Amitabh;Gruber, Jonathan;McKnight, Robin
在医疗保险计划中，由补充保险公司分摊的费用增加会产生财务外部性。我们研究了一项政策变化，该政策变化提高了加州退休公务员补充保险公司的患者成本分担。我们发现，医生访问和处方药使用具有弹性，类似于那些兰德健康保险实验（HIE）。然而，与HIE不同的是，我们发现在医院使用率增加方面存在实质性的“抵消”效应。费用分摊增加所节省的费用大部分归补充保险公司所有，而住院费用增加所节省的费用大部分归医疗保险公司所有。
In the Medicare program, increases in cost sharing by a supplemental insurer can exert financial externalities. We study a policy change that raised patient cost sharing for the supplemental insurer for retired public employees in California. We find that physician visits and prescription drug usage have elasticities that are similar to those of the RAND Health Insurance Experiment (HIE). Unlike the HIE, however, we find substantial "offset" effects in terms of increased hospital utilization. The savings from increased cost sharing accrue mostly to the supplemental insurer, while the costs of increased hospitalization accrue mostly to Medicare.