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How does health insurance copayment affect the use of medical services and health outcomes

健康保险共付额如何影响医疗服务的使用和健康结果

基本信息

批准号：
19K13700
负责人：
Wong ChunYee
金额：
$ 1.75万
依托单位：
International University of Japan
依托单位国家：
日本
项目类别：
Grant-in-Aid for Early-Career Scientists
财政年份：
2019
资助国家：
日本
起止时间：
2019-04-01 至 2024-03-31
项目状态：
已结题

来源：
https://kaken.nii.ac.jp/en/grant/KAKENHI-PROJECT-19K13700/
关键词：
health outcome healthcare health insurance health behaviour health behavior health outcomes Health Insurance Medical Services Health Outcomes

项目摘要

This project is aimed at investigating the effects of health insurance and related health policies on health outcomes. The data of Comprehensive Survey of Living Conditions (CSLC) were obtained to facilitate analyzing the health policy impacts on health outcomes of individuals in Japan. Since the co-payment of medical fees differs for those below 70 and between 70 and 74, and the share of medical fees changed in 2014, the threshold at age 70 and policy changes provide natural experiments to estimate the causal effects of coinsurance on health outcomes. By utilizing the data in 2013 and 2016, the method of difference-in-differences (DID) is adopted to estimate the average treatment effects of the change in co-payment on health outcomes. The results indicate that in general, decrease in health insurance coverage (i.e., increase in co-payment) reduces positive health behaviour. However, the impact on risky health behaviour is mixed. Furthermore, people with higher education level tend to have a stronger change in their behaviour for both positive and negative health behaviour. Besides, males have a larger decline in smoking but have a significant increase in alcohol consumption compared to females. The findings of the study have significant implications for policy-making: by understanding the effects of health insurance coverage on various health behaviors, policymakers can develop targeted interventions and strategies to encourage positive behavioral changes in different population segments.

该项目旨在调查健康保险和相关健康政策对健康结果的影响。为了便于分析卫生政策对日本个人健康结果的影响，获得了生活条件综合调查(CSLC)的数据。由于70岁以下和70至74岁之间的人共同支付医疗费用的情况不同，而且医疗费用的份额在2014年发生了变化，70岁的门槛和政策变化为估计共同保险对健康结果的因果影响提供了自然的实验。利用2013年和2016年的数据，采用差异法(DID)估计自付费用变化对健康结局的平均治疗效果。结果表明，总的来说，健康保险覆盖面的减少(即自付费用的增加)会减少积极的健康行为。然而，对危险健康行为的影响是喜忧参半的。此外，受教育程度越高的人，无论是积极的健康行为还是消极的健康行为，他们的行为变化都更大。此外，与女性相比，男性吸烟的减少幅度更大，但饮酒量却显著增加。研究结果对政策制定具有重要意义：通过了解医疗保险覆盖范围对各种健康行为的影响，政策制定者可以制定有针对性的干预措施和策略，以鼓励不同人群的积极行为变化。