The effect of cost-sharing on health care utilization and health outcomes

费用分摊对医疗保健利用和健康结果的影响

基本信息

批准号：
8663153
负责人：
SRIKANTH KADIYALA
金额：
$ 23.91万
依托单位：
RAND CORPORATION
依托单位国家：
美国
项目类别：
财政年份：
2013
资助国家：
美国
起止时间：
2013-06-01 至 2016-05-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8663153
关键词：
Accident and Emergency department Address Adult Advisory Committees Affect Age Age Distribution Ambulatory Care American Asthma Caring Chile Chronic Disease Control Groups Cost Sharing Costs and Benefits Data Detection Diabetes Mellitus Drug Prescriptions Effectiveness Elderly Evaluation Face General Population Goals Government Health Health Care Costs Health Insurance Health Planning Health Services Healthcare Heart Diseases Hospitals Household Hypertension Individual Insurance Knowledge Literature Low income Medical Medicare Mental Depression Outcome Outcome Measure Outpatients Patient Self-Report Patients Physicians Play Policies Population Prevention Preventive Procedures Provider Public Health Relative (related person)Research Design Review Literature Rice Role Running Services System Time Uninsured Variant Visit Wages base copayment cost design disorder prevention health care service utilization improved insight novel programs public health relevance research study

项目摘要

DESCRIPTION (provided by applicant): What are the effects of cost sharing on health care utilization and health outcomes? While tremendous progress has been made on the answer to this question there remain some noticeable gaps in this literature. Most importantly more studies are necessary to understand how cost sharing affects the treatment of non- elderly adults and outcomes related to chronic diseases. This study exploits knowledge of how the Chilean government assigns individuals to health insurance plans in the public health insurance program in Chile (FONASA) to understand how cost-sharing affects health insurance utilization and health outcomes for adults in the Chilean health insurance system. FONASA assigns individuals from all across the adult age distribution into health insurance plans with varying levels of cost- sharing (0%, 10% and 20%) based on individual wage and household size. Using a regression discontinuity research design we propose to exploit this plan assignment procedure and aim to estimate causal estimates of the effects of cost sharing on health care utilization and health outcomes. This study will examine the effects on a variety of health utilization and health outcomes measures including physician, hospital, emergency room visits and asthma, hypertension, diabetes and depression detection.

描述（由申请人提供）：成本共享对医疗保健利用和健康成果的影响是什么？尽管在这个问题的答案上取得了巨大进展，但在本文中仍然存在一些明显的差距。最重要的是，需要更多的研究来了解成本分配如何影响非老年人的治疗以及与慢性疾病有关的结果。这项研究利用了智利政府如何将个人分配给智利公共健康保险计划（FONASA）的知识，以了解智利健康保险系统中成人的健康保险利用和健康状况的影响。 Fonasa将整个成人年龄分配的个人分配到健康保险计划中，成本水平不同 - 根据个人工资和家庭规模，共享（0％，10％和20％）。使用回归不连续性研究设计，我们建议利用此计划分配程序，并旨在估算成本分担对医疗保健利用率和健康结果的影响的因果估计。这项研究将研究对各种健康利用和健康结果措施的影响，包括医师，医院，急诊室就诊和哮喘，高血压，糖尿病和抑郁症检测。