The impact of health care reform on hospital and preventive care: Evidence from Massachusetts

• 成果类型: Article
• 署名作者: Kolstad, Jonathan T.; Kowalski, Amanda E.
• 署名单位: University of Pennsylvania; Yale University; National Bureau of Economic Research
• 刊物名称: JOURNAL OF PUBLIC ECONOMICS
• ISSN/ISSBN: 0047-2727
• DOI: 10.1016/j.jpubeco.2012.07.003
• 发表日期: 2012
• 页码: 909-929
• 关键词: health; health care; Health reform; insurance; Hospitals; Massachusetts; Preventive care

摘要

In April 2006, Massachusetts passed legislation aimed at achieving near-universal health insurance coverage. The key features of this legislation were a model for national health reform, passed in March 2010. The reform gives us a novel opportunity to examine the impact of expansion to near-universal coverage state-wide. Among hospital discharges in Massachusetts, we find that the reform decreased uninsurance by 36% relative to its initial level and to other states. Reform affected utilization by decreasing length of stay, and the number of inpatient admissions originating from the emergency room. When we control for patient severity, we find evidence that preventable admissions decreased. At the same time, hospital cost growth did not increase. (C) 2012 Elsevier B.V. All rights reserved.