The Effect of Patient Cost Sharing on Utilization, Health, and Risk Protection

• 成果类型: Article
• 署名作者: Shigeoka, Hitoshi
• 署名单位: Simon Fraser University
• 刊物名称: AMERICAN ECONOMIC REVIEW
• ISSN/ISSBN: 0002-8282
• DOI: 10.1257/aer.104.7.2152
• 发表日期: 2014
• 页码: 2152-2184
• 关键词: INSURANCE EXPERIMENT; medical-care; coverage; demand; IMPACT; JAPAN; deductibles; 1st

摘要

This paper exploits a sharp reduction in patient cost sharing at age 70 in Japan, using a regression discontinuity design to examine its effect on utilization, health, and financial risk arising from out-of-pocket expenditures. Due to the national policy, cost sharing is 60-80 percent lower at age 70 than at age 69. I find that both outpatient and inpatient care are price sensitive among the elderly. While I find little impact on mortality and other health outcomes, the results show that reduced cost sharing is associated with lower -out-of-pocket expenditures, especially at the right tail of the distribution.