Abstract:
A headline result from the Oregon Health Insurance Experiment is that emergency room (ER) utilization increased. A seemingly contradictory result from the Massachusetts health reform is that ER utilization decreased. I reconcile both results by identifying treatment effect heterogeneity within the Oregon experiment and extrapolating it to Massachusetts. Even though Oregon compliers increased their ER utilization, they were adversely selected relative to Oregon never takers, who would have decreased their ER utilization. Massachusetts expanded coverage from a higher level to healthier compliers. Therefore, Massachusetts compliers are comparable to a subset of Oregon never takers, which can reconcile the results.
摘要:
俄勒冈州健康保险实验的一个标题结果是急诊室(ER)利用率增加。马萨诸塞州医疗改革的一个看似矛盾的结果是ER利用率下降。我通过在俄勒冈实验中确定治疗效果的异质性并将其推断到马萨诸塞州来调和这两个结果。即使俄勒冈州的同事增加了他们的ER利用率,相对于俄勒冈州从未接受过的人,谁会降低他们的ER利用率。马萨诸塞州将覆盖范围从更高的水平扩大到更健康的人。因此,马萨诸塞州的追随者与俄勒冈州的一部分从不接受者相当,可以调和结果。