IDEAS home Printed from https://ideas.repec.org/a/eee/jhecon/v39y2015icp259-272.html
   My bibliography  Save this article

Does seeing the doctor more often keep you out of the hospital?

Author

Listed:
  • Kaestner, Robert
  • Sasso, Anthony T. Lo

Abstract

By exploiting a unique health insurance benefit design, we provide novel evidence on the causal association between outpatient and inpatient care. Our results indicate that greater outpatient spending was associated with more hospital admissions: a $100 increase in outpatient spending was associated with a 1.9% increase in the probability of having an inpatient event and a 4.6% increase in inpatient spending among enrollees in our sample. Moreover, we present evidence that the increase in hospital admissions associated with greater outpatient spending was for conditions in which it is plausible to argue that the physician and patient could exercise discretion.

Suggested Citation

  • Kaestner, Robert & Sasso, Anthony T. Lo, 2015. "Does seeing the doctor more often keep you out of the hospital?," Journal of Health Economics, Elsevier, vol. 39(C), pages 259-272.
    • Handle: RePEc:eee:jhecon:v:39:y:2015:i:c:p:259-272
    DOI: 10.1016/j.jhealeco.2014.08.003
    as

    Download full text from publisher

    File URL: http://www.sciencedirect.com/science/article/pii/S016762961400099X
    Download Restriction: Full text for ScienceDirect subscribers only
    File URL: https://libkey.io/10.1016/j.jhealeco.2014.08.003?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    As the access to this document is restricted, you may want to look for a different version below or search for a different version of it.

    Other versions of this item:

    References listed on IDEAS

    as
    1. Kolstad, Jonathan T. & Kowalski, Amanda E., 2012. "The impact of health care reform on hospital and preventive care: Evidence from Massachusetts," Journal of Public Economics, Elsevier, vol. 96(11), pages 909-929.
    2. Pappas, G. & Hadden, W.C. & Kozak, L.J. & Fisher, G.F., 1997. "Potentially avoidable hospitalizations: Inequalities in rates between US socioeconomic groups," American Journal of Public Health, American Public Health Association, vol. 87(5), pages 811-816.
    3. Dafny, Leemore & Gruber, Jonathan, 2005. "Public insurance and child hospitalizations: access and efficiency effects," Journal of Public Economics, Elsevier, vol. 89(1), pages 109-129, January.
    4. Jeffrey Clemens & Joshua D. Gottlieb, 2014. "Do Physicians' Financial Incentives Affect Medical Treatment and Patient Health?," American Economic Review, American Economic Association, vol. 104(4), pages 1320-1349, April.
    5. Anthony T. Lo Sasso & Lorens A. Helmchen & Robert Kaestner, 2010. "The Effects of Consumer‐Directed Health Plans on Health Care Spending," Journal of Risk & Insurance, The American Risk and Insurance Association, vol. 77(1), pages 85-103, March.
    6. McGuire, Thomas G., 2000. "Physician agency," Handbook of Health Economics, in: A. J. Culyer & J. P. Newhouse (ed.), Handbook of Health Economics, edition 1, volume 1, chapter 9, pages 461-536, Elsevier.
    7. Kaestner, R. & Joyce, T. & Racine, A., 2001. "Medicaid eligibility and the incidence of ambulatory care sensitive hospitalizations for children," Social Science & Medicine, Elsevier, vol. 52(2), pages 305-313, January.
    8. Amy Finkelstein & Sarah Taubman & Bill Wright & Mira Bernstein & Jonathan Gruber & Joseph P. Newhouse & Heidi Allen & Katherine Baicker, 2012. "The Oregon Health Insurance Experiment: Evidence from the First Year," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 127(3), pages 1057-1106.
    9. Michael Anderson & Carlos Dobkin & Tal Gross, 2012. "The Effect of Health Insurance Coverage on the Use of Medical Services," American Economic Journal: Economic Policy, American Economic Association, vol. 4(1), pages 1-27, February.
    10. Manning, Willard G, et al, 1987. "Health Insurance and the Demand for Medical Care: Evidence from a Randomized Experiment," American Economic Review, American Economic Association, vol. 77(3), pages 251-277, June.
    11. Grossman, Michael, 1972. "On the Concept of Health Capital and the Demand for Health," Journal of Political Economy, University of Chicago Press, vol. 80(2), pages 223-255, March-Apr.
    12. Amitabh Chandra & Jonathan Gruber & Robin McKnight, 2010. "Patient Cost-Sharing and Hospitalization Offsets in the Elderly," American Economic Review, American Economic Association, vol. 100(1), pages 193-213, March.
    13. Miller, Sarah, 2012. "The effect of insurance on emergency room visits: An analysis of the 2006 Massachusetts health reform," Journal of Public Economics, Elsevier, vol. 96(11), pages 893-908.
    14. Robert Kaestner & Nasreen Khan, 2012. "Medicare Part D and Its Effect on the Use of Prescription Drugs and Use of Other Health Care Services of the Elderly," Journal of Policy Analysis and Management, John Wiley & Sons, Ltd., vol. 31(2), pages 253-279, March.
    15. A. J. Culyer & J. P. Newhouse (ed.), 2000. "Handbook of Health Economics," Handbook of Health Economics, Elsevier, edition 1, volume 1, number 1.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Toshiaki Iizuka & Hitoshi Shigeoka, 2018. "Free for Children? Patient Cost-sharing and Healthcare Utilization," NBER Working Papers 25306, National Bureau of Economic Research, Inc.
    2. Keegan, Conor & Brick, Aoife & García-Rodríguez, Abián & Hill, Leonie, 2022. "Projections of workforce requirements for public acute hospitals in Ireland, 2019–2035: a regional analysis based on the hippocrates model," Research Series, Economic and Social Research Institute (ESRI), number RS147, June.
    3. Péter Elek & Tamás Molnár & Balázs Váradi, 2019. "The closer the better: does better access to outpatient care prevent hospitalization?," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 20(6), pages 801-817, August.
    4. Wen He, 2022. "Effects of establishing a financing scheme for outpatient care on inpatient services: empirical evidence from a quasi-experiment in China," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 23(1), pages 7-22, February.
    5. Markus Gehrsitz & Morgan C. Williams, "undated". "The Effects of Compulsory Schooling on Health and Hospitalization over the Life Cycle," Working Papers 2303, University of Strathclyde Business School, Department of Economics, revised May 2020.
    6. Chen Jiajia & van den Berghe Eunkyung & Kaestner Robert, 2019. "Is Primary Care A Substitute or Complement for Other Medical Care? Evidence from Medicaid," Forum for Health Economics & Policy, De Gruyter, vol. 22(1), pages 1-36, June.
    7. Yuanyuan Ma & Anne Nolan, 2017. "Public Healthcare Entitlements and Healthcare Utilisation among the Older Population in Ireland," Health Economics, John Wiley & Sons, Ltd., vol. 26(11), pages 1412-1428, November.
    8. L. F. Andrade & T. Rapp & C. Sevilla-Dedieu, 2018. "Quality of diabetes follow-up care and hospital admissions," International Journal of Health Economics and Management, Springer, vol. 18(2), pages 153-167, June.
    9. Walsh, Brendan & Nolan, Anne & Brick, Aoife & Keegan, Conor, 2019. "Did the expansion of free GP care impact demand for Emergency Department attendances? A difference-in-differences analysis," Social Science & Medicine, Elsevier, vol. 222(C), pages 101-111.
    10. Engy Ziedan & Kosali I. Simon & Coady Wing, 2022. "Mortality Effects of Healthcare Supply Shocks: Evidence Using Linked Deaths and Electronic Health Records," NBER Working Papers 30553, National Bureau of Economic Research, Inc.

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Barbaresco, Silvia & Courtemanche, Charles J. & Qi, Yanling, 2015. "Impacts of the Affordable Care Act dependent coverage provision on health-related outcomes of young adults," Journal of Health Economics, Elsevier, vol. 40(C), pages 54-68.
    2. Jungtaek Lee, 2018. "Effects of health insurance coverage on risky behaviors," Health Economics, John Wiley & Sons, Ltd., vol. 27(4), pages 762-777, April.
    3. Charles Courtemanche & James Marton & Benjamin Ukert & Aaron Yelowitz & Daniela Zapata, 2018. "Early Effects of the Affordable Care Act on Health Care Access, Risky Health Behaviors, and Self‐Assessed Health," Southern Economic Journal, John Wiley & Sons, vol. 84(3), pages 660-691, January.
    4. Mark Duggan & Atul Gupta & Emilie Jackson, 2022. "The Impact of the Affordable Care Act: Evidence from California's Hospital Sector," American Economic Journal: Economic Policy, American Economic Association, vol. 14(1), pages 111-151, February.
    5. Dunn, Abe & Shapiro, Adam Hale, 2015. "Physician payments under health care reform," Journal of Health Economics, Elsevier, vol. 39(C), pages 89-105.
    6. Andrey Aistov & Ekaterina Aleksandrova & Christopher J. Gerry, 2021. "Voluntary private health insurance, health-related behaviours and health outcomes: evidence from Russia," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 22(2), pages 281-309, March.
    7. Sebastian Tello Trillo & Ausmita Ghosh & Kosali Simon & Johanna Catherine Maclean, 2015. "Losing Medicaid: What happens to hospitalizations?," NBER Working Papers 21580, National Bureau of Economic Research, Inc.
    8. Thomas Buchmueller & John C. Ham & Lara D. Shore-Sheppard, 2015. "The Medicaid Program," NBER Chapters, in: Economics of Means-Tested Transfer Programs in the United States, Volume 1, pages 21-136, National Bureau of Economic Research, Inc.
    9. Akosa Antwi, Yaa & Moriya, Asako S. & Simon, Kosali I., 2015. "Access to health insurance and the use of inpatient medical care: Evidence from the Affordable Care Act young adult mandate," Journal of Health Economics, Elsevier, vol. 39(C), pages 171-187.
    10. Toshiaki Iizuka & Hitoshi Shigeoka, 2018. "Free for Children? Patient Cost-sharing and Healthcare Utilization," NBER Working Papers 25306, National Bureau of Economic Research, Inc.
    11. Nilsson, Anton & Paul, Alexander, 2018. "Patient cost-sharing, socioeconomic status, and children's health care utilization," Journal of Health Economics, Elsevier, vol. 59(C), pages 109-124.
    12. Jacqueline Fiore, 2017. "The Impact of the Affordable Care Act's Medicaid Expansion on Medicaid Spending by Health Care Service Category," Working Papers 1706, Tulane University, Department of Economics, revised Mar 2018.
    13. Mengna Luan & Wenjing Shi & Zhigang Tao & Hongjie Yuan, 2023. "When patients have better insurance coverage in China: Provider incentives, costs, and quality of care," Economics of Transition and Institutional Change, John Wiley & Sons, vol. 31(4), pages 1073-1106, October.
    14. Rabideau, Brendan & Eisenberg, Matthew D. & Reid, Rachel & Sood, Neeraj, 2021. "Effects of employer-offered high-deductible plans on low-value spending in the privately insured population," Journal of Health Economics, Elsevier, vol. 76(C).
    15. Yörük Barış K., 2017. "Health Insurance Coverage and Risky Health Behaviors among Young Adults," The B.E. Journal of Economic Analysis & Policy, De Gruyter, vol. 17(3), pages 1-21, July.
    16. Maclean, Johanna Catherine & Tello-Trillo, Sebastian & Webber, Douglas, 2023. "Losing insurance and psychiatric hospitalizations," Journal of Economic Behavior & Organization, Elsevier, vol. 205(C), pages 508-527.
    17. Haviland, Amelia M. & Eisenberg, Matthew D. & Mehrotra, Ateev & Huckfeldt, Peter J. & Sood, Neeraj, 2016. "Do “Consumer-Directed” health plans bend the cost curve over time?," Journal of Health Economics, Elsevier, vol. 46(C), pages 33-51.
    18. Courtemanche, Charles & Friedson, Andrew & Koller, Andrew P. & Rees, Daniel I., 2019. "The affordable care act and ambulance response times," Journal of Health Economics, Elsevier, vol. 67(C).
    19. Dunn, Abe & Knepper, Matthew & Dauda, Seidu, 2021. "Insurance expansions and hospital utilization: Relabeling and reabling?," Journal of Health Economics, Elsevier, vol. 78(C).
    20. Kolstad, Jonathan T. & Kowalski, Amanda E., 2012. "The impact of health care reform on hospital and preventive care: Evidence from Massachusetts," Journal of Public Economics, Elsevier, vol. 96(11), pages 909-929.

    More about this item

    Keywords

    High deductible health insurance; Consumer-driven health insurance; Inpatient care; Outpatient care; Health reimbursement arrangement; Health insurance plan design;
    All these keywords.

    JEL classification:

    • I13 - Health, Education, and Welfare - - Health - - - Health Insurance, Public and Private

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:eee:jhecon:v:39:y:2015:i:c:p:259-272. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Catherine Liu (email available below). General contact details of provider: http://www.elsevier.com/locate/inca/505560 .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.