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Healthcare consumption after a change in health insurance coverage: a French quasi-natural experiment

Author

Listed:
  • Christine Sevilla-Dedieu

    () (MGEN Foundation for Public Health)

  • Nathalie Billaudeau

    (MGEN Foundation for Public Health)

  • Alain Paraponaris

    (Aix-Marseille Univ, CNRS, EHESS, Centrale Marseille, AMSE
    ORS PACA, South-Eastern Health Observatory)

Abstract

Background Compared with the number of studies performed in the United States, few studies have been conducted on the link between health insurance and healthcare consumption in Europe, likely because most European countries have compulsory national health insurance (NHI) or a national health service (NHS). Recently, a major French private insurer, offering voluntary complementary coverage in addition to the compulsory NHI, replaced its single standard package with a range of offers from basic coverage (BC) to extended coverage (EC), providing a quasi-natural experiment to test theoretical assumptions about consumption patterns. Methods Reimbursement claim data from 85,541 insurees were analysed from 2009 to 2018. Insurees who opted for EC were matched to those still covered by BC with similar characteristics. Difference-in-differences (DiD) models were used to compare both the monetary value and physical quantities of healthcare consumption before and after the change in coverage. Results As expected, the DiD models revealed a strongly significant, though transitory (mainly during the first year), increase after the change in coverage for EC insurees, particularly for costly care such as dental prostheses and spectacles. Surprisingly, consumption seemed to precede the change in coverage, suggesting that one possible determinant of opting for more coverage may be previous unplanned expenses. Conclusion Both catching-up behaviour and moral hazard are likely to play a role in the observed increase in healthcare consumption.

Suggested Citation

  • Christine Sevilla-Dedieu & Nathalie Billaudeau & Alain Paraponaris, 2020. "Healthcare consumption after a change in health insurance coverage: a French quasi-natural experiment," Health Economics Review, Springer, vol. 10(1), pages 1-10, December.
  • Handle: RePEc:spr:hecrev:v:10:y:2020:i:1:d:10.1186_s13561-020-00275-y
    DOI: 10.1186/s13561-020-00275-y
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    References listed on IDEAS

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    1. Chris Sampson’s journal round-up for 6th July 2020
      by Chris Sampson in The Academic Health Economists' Blog on 2020-07-06 11:00:00

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