私人保险、选择与医疗利用

Private Insurance, Selection, and Health Care Use

Journal of Business & Economic Statistics · 2006
被引 30
人大 AABS 4

中文导读

用贝叶斯方法分解私人保险与无保险人群医疗利用差异,发现自选择效应平均解释医生就诊差异的50%以上。

Abstract

Observed differences in medical utilization between the privately insured and uninsured reflect the combined effects of self-selection and insurance incentives (moral hazard). This article provides a Bayesian framework for decomposing the disparity into incentive and selection components. The effect of self-selection in private insurance on the number of doctor visits is estimated using a multiyear sample of the U.S. adult non-Medicare population obtained from the Medical Expenditure Panel Survey. We use a flexible econometric framework based on the "Roy model" and develop a Markov chain Monte Carlo algorithm. We estimate the distribution of treatment effects and find strong evidence indicating selection, which accounts, on average, for 50% or more of the observed disparity in doctor visits.

私人保险逆向选择道德风险医疗利用