Does Public Insurance Improve the Efficiency of Medical Care? Medicaid Expansions and Child Hospitalizations
AbstractOne of the benefits commonly claimed for expanded public health insurance is improved efficiency of medical care delivery, but this claim has little rigorous empirical support. We provide such support by assessing the impact of the Medicaid expansions over the 1983-1996 period on the incidence of avoidable hospitalizations. We find that expanded public insurance eligibility leads to a significant decline in avoidable hospitalization: over this period Medicaid eligibility expansions were associated with a 22% decline in avoidable hospitalization. But we also find that there is a countervailing and larger impact in terms of increased access to hospital care for newly eligible children, so that there is an overall 10% rise in child hospitalizations due to the expansions. The expansions have mixed implications for treatment intensity, but appear to be associated with a significant shift in the types of hospitals at which children are treated, with fewer children treated in public hospitals and more in for-profit facilities.
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Bibliographic InfoPaper provided by National Bureau of Economic Research, Inc in its series NBER Working Papers with number 7555.
Date of creation: Feb 2000
Date of revision:
Publication status: published as "Public Insurance and Child Hospitalizations: Access and Efficiency Effects," Journal of Public Economics, 2005, 89(1): 109-129
Note: CH HC PE
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Find related papers by JEL classification:
- I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health
- H51 - Public Economics - - National Government Expenditures and Related Policies - - - Government Expenditures and Health
This paper has been announced in the following NEP Reports:
- NEP-ALL-2000-02-21 (All new papers)
- NEP-HEA-2000-02-21 (Health Economics)
- NEP-IAS-2000-02-21 (Insurance Economics)
- NEP-PBE-2000-02-21 (Public Economics)
- NEP-PUB-2000-02-21 (Public Finance)
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