Public and Private Options in Practice: The Military Health Systems

• 成果类型: Article
• 署名作者: Frakes, Michael D.; Gruber, Jonathan; Justicz, Timothy
• 署名单位: Duke University; National Bureau of Economic Research; Massachusetts Institute of Technology (MIT)
• 刊物名称: AMERICAN ECONOMIC JOURNAL-ECONOMIC POLICY
• ISSN/ISSBN: 1945-7731
• DOI: 10.1257/pol.20210625
• 发表日期: 2023
• 页码: 37-74
• 关键词: hospital ownership; regional-variations; service quality; care evidence; outcomes; IMPACT

摘要

Recent debates over health care reform, including in the context of the Military Health System (MHS) and Veterans Administration, highlight the dispute between public and private provision of health care services. Using novel data on childbirth claims from the MHS and drawing on the combination of plausibly exogenous patient moves and heterogeneity across bases in the availability of base hos-pitals, we identify the impact of receiving obstetrical care on versus off military bases. We find evidence that off-base care is associated with slightly greater resource intensity, but also notably better out-comes, suggesting marginal efficiency gains from care privatization. (JEL H51, H56, I11, I18, J13, L33)