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The effect of insurance on emergency room visits: An analysis of the 2006 Massachusetts health reform

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  • Miller, Sarah
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    Abstract

    This paper analyzes the impact of a major health reform in Massachusetts on emergency room (ER) visits. I exploit the variation in pre-reform uninsurance rates across counties to identify the causal effect of the reform on ER visits. My estimates imply that the reform reduced ER usage by between 5 and 8%, nearly all of which is accounted for by a reduction in non-urgent visits that could be treated in alternative settings. The reduction in emergency room visits is most pronounced during regular office hours when physician's offices are likely to be open. In contrast, I find no effect for non-preventable emergencies such as heart attacks. These estimates are consistent with a large causal effect of insurance on ER visits and imply that expanding insurance coverage could have a substantial impact on the efficiency of health services.

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    File URL: http://www.sciencedirect.com/science/article/pii/S0047272712000850
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    Bibliographic Info

    Article provided by Elsevier in its journal Journal of Public Economics.

    Volume (Year): 96 (2012)
    Issue (Month): 11 ()
    Pages: 893-908

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    Handle: RePEc:eee:pubeco:v:96:y:2012:i:11:p:893-908

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    Web page: http://www.elsevier.com/locate/inca/505578

    Related research

    Keywords: Health; Health insurance; Emergency room use;

    References

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    1. Kowalski, A.; & Kolstad, J.;, 2010. "The Impact of an Individual Health Insurance Mandate on Hospital and Preventive Care: Evidence from Massachusetts," Health, Econometrics and Data Group (HEDG) Working Papers 10/18, HEDG, c/o Department of Economics, University of York.
    2. Amy Finkelstein & Sarah Taubman & Bill Wright & Mira Bernstein & Jonathan Gruber & Joseph P. Newhouse & Heidi Allen & Katherine Baicker & The Oregon Health Study Group, 2011. "The Oregon Health Insurance Experiment: Evidence from the First Year," NBER Working Papers 17190, National Bureau of Economic Research, Inc.
    3. Sharon K. Long & Karen Stockley & Alshadye Yemane, 2009. "Another Look at the Impacts of Health Reform in Massachusetts: Evidence Using New Data and a Stronger Model," American Economic Review, American Economic Association, vol. 99(2), pages 508-11, May.
    4. Anna Aizer, 2007. "Public Health Insurance, Program Take-Up, and Child Health," The Review of Economics and Statistics, MIT Press, vol. 89(3), pages 400-415, August.
    5. Marianne Bertrand & Esther Duflo & Sendhil Mullainathan, 2004. "How Much Should We Trust Differences-in-Differences Estimates?," The Quarterly Journal of Economics, MIT Press, vol. 119(1), pages 249-275, February.
    6. Amy Finkelstein, 2007. "The Aggregate Effects of Health Insurance: Evidence from the Introduction of Medicare," The Quarterly Journal of Economics, MIT Press, vol. 122(1), pages 1-37, 02.
    7. 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.
    8. Finkelstein, Amy, et al., 2011. "The Oregon Health Insurance Experiment: Evidence from the First Year," Working Paper Series rwp11-040, Harvard University, John F. Kennedy School of Government.
    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. Jonathan Gruber, 2008. "Massachusetts Health Care Reform: The View From One Year Out," Risk Management and Insurance Review, American Risk and Insurance Association, vol. 11(1), pages 51-63, 03.
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    Cited by:
    1. Mazumder, Bhashkar & Miller, Sarah, 2014. "The Effects of the Massachusetts Health Reform on Financial Distress," Working Paper Series WP-2014-1, Federal Reserve Bank of Chicago.

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