【主题】Cover More for Less: Effect of Targeted Cost Sharing on Health Care Utilization and Expenditure
【报告人】石菊, 北京大学经济学院，长聘副教授
【时间】2023年3月27日周一上午10:00-11:30
【语言】英文
【摘要】Cost sharing is central to health insurance design to achieve the seemingly conflicting objectives of controlling costs and ensuring access to care. We investigate how to achieve both objectives by leveraging a pilot insurance program in rural China that introduced insurance coverage of prescription drugs to two chronic diseases—hypertension and diabetes. Exploiting a unique administrative medical dataset, we find the targeted cost sharing increased the use of outpatient care and sharply reduced inpatient admissions, a phenomenon termed the hospitalization offset, and achieved a substantial saving of total medical expenditure. Three additional findings are worth noting. First, the hospitalization offset was achieved by stimulating regular outpatient visits and improving patient health rather than a simple substitution between inpatient and outpatient services. Second, the reduction in hospitalization was observed for targeted diseases and more so for nontargeted chronic diseases, suggesting a strong cross-disease spillover effect in disease management. Third, learning contributes importantly to the hospitalization offset. Our findings have important implications for the value-based insurance design.
【报告人简介】石菊博士是北京大学经济学院长聘副教授，北京大学全球健康研究院双聘副教授。她的专业是健康经济学，长期致力于我国医疗卫生体制改革研究。她的研究关注医疗保险制度的制定与评估，包括医保支付制度的设计与政策评估、医疗保险报销制度的设计与对患者行为的影响，以及药品政策对医疗系统的影响。石菊博士本科毕业于清华大学，博士毕业于美国波士顿大学。加入北京大学之前，曾在美国哈佛大学担任博士后研究员。她的多篇研究论文发表于国际国内顶级期刊，并承担了多项国家级和省部级课题研究。她同时担任北京外国经济学说研究会副秘书长、北京市食品安全地方标准审评委员会顾问。