The effect of insurance on emergency room visits: An analysis of the 2006 Massachusetts health reform

• 成果类型: Article
• 署名作者: Miller, Sarah
• 署名单位: Robert Wood Johnson Foundation (RWJF); University of Michigan System; University of Michigan; University of Notre Dame
• 刊物名称: JOURNAL OF PUBLIC ECONOMICS
• ISSN/ISSBN: 0047-2727
• DOI: 10.1016/j.jpubeco.2012.07.004
• 发表日期: 2012
• 页码: 893-908
• 关键词: health; health insurance; Emergency room use

摘要

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.