Separating selection and incentive effects : an econometric study of Swiss health insurance claims data

Details

Serval ID
serval:BIB_3B20CE7FA4EE
Type
Report: a report published by a school or other institution, usually numbered within a series.
Publication sub-type
Working paper: Working papers contain results presented by the author. Working papers aim to stimulate discussions between scientists with interested parties, they can also be the basis to publish articles in specialized journals
Collection
Publications
Institution
Title
Separating selection and incentive effects : an econometric study of Swiss health insurance claims data
Author(s)
Gardiol Lucien, Geoffard Pierre-Yves, Grandchamp Chantal
Publisher
Ecole Normale Supérieure, Département et laboratoire d'économie théorique et appliquée
Institution details
DELTA (Département et laboratoire d'économie théorique et appliquée)
Address
Paris
Issued date
2003
Number
2003-27
Genre
Working Paper
Language
english
Number of pages
22
Abstract
This paper presents an empirical analysis of the link between health insurance coverage and health care expenditures. We use claims data for over 60 000 adult individuals covered by a major Swiss Health Insurance Fund, followed for four years. In the Swiss health insurance system, each individual can choose between five plans, corresponding to different levels of annual deductible. The data show a strong positive correlation between coverage and expenditure. We provide a simple method to separate selection effects (due to individual choice of coverage) and incentive effects ("moral hazard"). The method only requires that there exists an observable variable: 1. correlated with the unobservable health status; 2. not affected by incentives. The analysis of mortality rates indicates important selection effects, which is confirmed by the data on inpatient care. However, the positive correlation between coverage and outpatient expenditure is not fully explained by selection effects, and moral hazard effects are of the same order of magnitude. [Authors]
Keywords
Insurance, Health , Health Expenditures
Create date
14/03/2008 10:21
Last modification date
20/08/2019 13:31
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