Patient Cost-Sharing and Healthcare Utilization in Early Childhood: Evidence from a Regression Discontinuity Design

• 成果类型: Article
• 署名作者: Han, Hsing-Wen; Lien, Hsien-Ming; Yang, Tzu-Ting
• 署名单位: Tamkang University; National Chengchi University; Academia Sinica - Taiwan
• 刊物名称: AMERICAN ECONOMIC JOURNAL-ECONOMIC POLICY
• ISSN/ISSBN: 1945-7731
• DOI: 10.1257/pol.20170009
• 发表日期: 2020
• 页码: 238-278
• 关键词: emergency-department; socioeconomic-status; medical-care; insurance; IMPACT; RISK; hospitalization; birth; copayment; benefits

摘要

This paper estimates the price elasticity of healthcare utilization in early childhood. We employ a regression discontinuity design by exploiting a subsidy that reduces patient cost-sharing for children under age 3 in Taiwan. Using longitudinal medical claims of over 410,000 children, we find a modest price elasticity of outpatient expenditure (e.g., -0.10 for regular outpatient care). Furthermore, increased cost-sharing at age 3 largely decreases the chance of visiting high-intensity healthcare providers (e.g., teaching hospitals) for minor illnesses. In contrast, children's utilization of inpatient care is price insensitive, providing a rationale for full inpatient care coverage to children.