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首页> 外文期刊>Journal of health economics >Moral hazard and the demand for health services: A matching estimator approach
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Moral hazard and the demand for health services: A matching estimator approach

机译：道德风险与对医疗服务的需求：一种匹配的估算器方法

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摘要

We estimate the impact of extra health insurance coverage beyond a National Health System on the demand for several health services. Traditionally, the literature has tried to deal with the endogeneity of the private (extra) insurance decision by finding instrumental variables. Since a priori instrumental variables are hard to find we take a different approach. We focus on the most common health insurance plan in Portugal, ADSE, which is given to all civil servants and their dependents. We argue that this insurance is exogenous, i.e., not correlated with the beneficiaries' health status. This identifying assumption allows us to estimate the impact of having ADSE coverage on the demand for three different health services using a matching estimator technique. The health services used are number of visits, number of blood and urine tests, and the probability of visiting a dentist. Results show large positive effects of ADSE coverage for number of visits and tests among the young (18-30 years old) but only the latter is statistically significantly different from zero. The effects represent 21.8% and 30% of the average number of visits and tests for the young. On the contrary, we find no evidence of moral hazard on the probability of visiting a dentist.
机译：我们估算了超出国家卫生系统的额外健康保险覆盖范围对几种医疗服务需求的影响。传统上，文献试图通过寻找工具变量来处理私人（额外）保险决定的内生性。由于很难找到先验的工具变量，因此我们采用了不同的方法。我们专注于葡萄牙最常见的健康保险计划ADSE，该计划适用于所有公务员及其家属。我们认为这种保险是外生的，即与受益人的健康状况无关。这种确定性的假设使我们能够使用匹配的估算器技术估算拥有ADSE覆盖范围对三种不同医疗服务需求的影响。使用的保健服务包括就诊次数，血液和尿液检查次数以及看牙医的可能性。结果显示，ADSE覆盖对年轻人（18至30岁）的访问和测试次数有很大的积极影响，但只有后者在统计学上显着不同于零。这些影响分别代表年轻人平均造访和测试次数的21.8％和30％。相反，我们没有发现看牙医的道德风险的证据。

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