Pcost-sharing, socioeconomic status, and children's health care utilization
Pcost-sharing, socioeconomic status, and children's health care utilization
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DOI：
10.1016/j.jhealeco.2018.03.006
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发表时间：
2018-05-01
影响因子：
3.5
通讯作者：
Paul, Alexander
中科院分区：
文献类型：
--
作者：
Nilsson, Anton;Paul, Alexander
本文估计了费用分担对儿童和青少年使用医疗保健的需求的影响。我们使用了一个大型的人口范围的登记数据集，包括与医疗保健系统的接触以及家庭收入的详细信息。使用两种不同的估计策略：回归不连续设计，利用年龄阈值以上的费用收取，利用政策变化的差异中的差异模型。我们还估计了组合回归不连续性差异模型，该模型考虑了由成本分摊以外的因素引起的年龄阈值周围的不连续性。我们发现，当保健是免费的，个人增加了他们的医生访问的数量由5- 10%。在童年中期和青春期，影响是相似的，并由低收入家庭的人驱动。收入群体之间的差异不能用与收入相关的其他因素来解释，如母亲的教育程度。(C)2018 Elsevier B. V.版权所有。
This paper estimates the effect of cost-sharing on the demand for children's and adolescents' use of medical care. We use a large population-wide registry dataset including detailed information on contacts with the health care system as well as family income. Two different estimation strategies are used: regression discontinuity design exploiting age thresholds above which fees are charged, and difference in-differences models exploiting policy changes. We also estimate combined regression discontinuity difference-in-differences models that take into account discontinuities around age thresholds caused by factors other than cost-sharing. We find that when care is free of charge, individuals increase their number of doctor visits by 5-10%. Effects are similar in middle childhood and adolescence, and are driven by those from low-income families. The differences across income groups cannot be explained by other factors that correlate with income, such as maternal education. (C) 2018 Elsevier B.V. All rights reserved.