Adverse selection and the effect of health insurance on utilization of prescribed medicine among patients with chronic conditions.

Yuriy Pylypchuk
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引用次数: 4

Abstract

Purpose: To examine the effects of health insurance types on the use of prescribed medication that treat patients with hypertension, diabetes, and asthma. The study distinguishes between individuals with private health maintenance organization (HMO) plans and private non-HMO plans. The study also distinguishes between people with health insurance and drug coverage and people with health insurance and no drug coverage.

Methods: Joint discrete factor models are estimated to control for endogeneity of each type of coverage.

Findings: The main findings suggest that the effect of health insurance varies across patients with different conditions. The strongest and most significant effect is evident among patients with hypertension while the weakest and least significant is among patients with asthma. These findings suggest that patients with asymptomatic conditions are more likely to exhibit moral hazard than patients with conditions that impose immediate impairment. Additional results suggest that, relative to the uninsured and people with health insurance but no drug coverage, patients with drug coverage are more likely to initiate drug therapy and to consume more medications.

Originality: The results of the study indicate that moral hazard of drug utilization is condition specific. The variation in "silence" of conditions' symptoms could be a key reason for difference in insurance effects among patients with hypertension, diabetes, and asthma.

逆向选择及健康保险对慢性病患者处方药使用的影响。
目的:探讨医疗保险类型对高血压、糖尿病和哮喘患者处方药使用的影响。该研究区分了私人健康维护组织(HMO)计划和私人非HMO计划的个人。该研究还区分了有医疗保险和药物保险的人和有医疗保险但没有药物保险的人。方法:估计联合离散因子模型来控制每种覆盖类型的内生性。研究结果:主要研究结果表明,医疗保险的效果在不同疾病的患者之间存在差异。在高血压患者中效果最强、最显著,在哮喘患者中效果最弱、最不显著。这些发现表明,无症状的患者比有立即损害的患者更有可能表现出道德风险。其他结果表明,相对于没有保险和有健康保险但没有药物保险的人,有药物保险的患者更有可能开始药物治疗并消耗更多的药物。独创性:研究结果表明,药物使用的道德风险是特定条件的。疾病症状“沉默”的差异可能是高血压、糖尿病和哮喘患者的保险效果不同的关键原因。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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