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The Effects of Patient Cost-Sharing on Adolescents' Healthcare Utilization and Financial Risk Protection: Evidence from South Korea

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  • Kim, Seonghoon

    (Singapore Management University)

  • Koh, Kanghyock

    (Korea University)

  • Lyou, Wonjun

    (Ohio State University)

Abstract

We examine the effects of patient cost-sharing on adolescents' healthcare utilization and out-of-pocket medical expenditures by exploiting the healthcare reform in South Korea that lowered the coinsurance rate for inpatient care from 20% to 5% for children under 16. We apply a difference-in-regression-discontinuities design using administrative claims data. We find that the reform increased adolescents' inpatient care utilization. It also reduced out-of-pocket healthcare expenditures. This effect was larger among low-income households, facilitating income redistribution. However, the lack of evidence on health improvements and household consumption spending responses suggests that generous patient cost-sharing for adolescent healthcare may cause efficiency losses.

Suggested Citation

  • Kim, Seonghoon & Koh, Kanghyock & Lyou, Wonjun, 2024. "The Effects of Patient Cost-Sharing on Adolescents' Healthcare Utilization and Financial Risk Protection: Evidence from South Korea," IZA Discussion Papers 16897, Institute of Labor Economics (IZA).
  • Handle: RePEc:iza:izadps:dp16897
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    1. Richard Bluhm & Maxim Pinkovskiy, 2021. "The spread of COVID-19 and the BCG vaccine: A natural experiment in reunified Germany," The Econometrics Journal, Royal Economic Society, vol. 24(3), pages 353-376.
    2. Manasi Deshpande, 2016. "Does Welfare Inhibit Success? The Long-Term Effects of Removing Low-Income Youth from the Disability Rolls," American Economic Review, American Economic Association, vol. 106(11), pages 3300-3330, November.
    3. Benedicte Apouey & Andrew E. Clark, 2015. "Winning Big but Feeling no Better? The Effect of Lottery Prizes on Physical and Mental Health," Health Economics, John Wiley & Sons, Ltd., vol. 24(5), pages 516-538, May.
    4. Andrew Gelman & Guido Imbens, 2019. "Why High-Order Polynomials Should Not Be Used in Regression Discontinuity Designs," Journal of Business & Economic Statistics, Taylor & Francis Journals, vol. 37(3), pages 447-456, July.
    5. Lee, David S. & Card, David, 2008. "Regression discontinuity inference with specification error," Journal of Econometrics, Elsevier, vol. 142(2), pages 655-674, February.
    6. Camille Landais, 2015. "Assessing the Welfare Effects of Unemployment Benefits Using the Regression Kink Design," American Economic Journal: Economic Policy, American Economic Association, vol. 7(4), pages 243-278, November.
    7. Hsing-Wen Han & Hsien-Ming Lien & Tzu-Ting Yang, 2020. "Patient Cost-Sharing and Healthcare Utilization in Early Childhood: Evidence from a Regression Discontinuity Design," American Economic Journal: Economic Policy, American Economic Association, vol. 12(3), pages 238-278, August.
    8. 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.
    9. 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.
    10. Toshiaki Iizuka & Hitoshi Shigeoka, 2022. "Is Zero a Special Price? Evidence from Child Health Care," American Economic Journal: Applied Economics, American Economic Association, vol. 14(4), pages 381-410, October.
    11. Toshiaki Iizuka & Hitoshi Shigeoka, 2023. "Asymmetric Demand Response When Prices Increase and Decrease: The Case of Child Health Care," The Review of Economics and Statistics, MIT Press, vol. 105(5), pages 1325-1333, September.
    12. Hitoshi Shigeoka, 2014. "The Effect of Patient Cost Sharing on Utilization, Health, and Risk Protection," American Economic Review, American Economic Association, vol. 104(7), pages 2152-2184, July.
    13. Hilary W. Hoynes & Ankur J. Patel, 2018. "Effective Policy for Reducing Poverty and Inequality?: The Earned Income Tax Credit and the Distribution of Income," Journal of Human Resources, University of Wisconsin Press, vol. 53(4), pages 859-890.
    14. Veronica Grembi & Tommaso Nannicini & Ugo Troiano, 2016. "Do Fiscal Rules Matter?," American Economic Journal: Applied Economics, American Economic Association, vol. 8(3), pages 1-30, July.
    15. Jeffrey Clemens & Joshua D. Gottlieb, 2017. "In the Shadow of a Giant: Medicare’s Influence on Private Physician Payments," Journal of Political Economy, University of Chicago Press, vol. 125(1), pages 1-39.
    16. Fukushima, Kazuya & Mizuoka, Sou & Yamamoto, Shunsuke & Iizuka, Toshiaki, 2016. "Patient cost sharing and medical expenditures for the Elderly," Journal of Health Economics, Elsevier, vol. 45(C), pages 115-130.
    17. Janet Currie, 2020. "Child health as human capital," Health Economics, John Wiley & Sons, Ltd., vol. 29(4), pages 452-463, April.
    18. Amitabh Chandra & Evan Flack & Ziad Obermeyer, 2021. "The Health Costs of Cost-Sharing," NBER Working Papers 28439, National Bureau of Economic Research, Inc.
    19. 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.
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    More about this item

    Keywords

    consumption spending; income redistribution; out-of-pocket expenditure; healthcare utilization; patient cost-sharing; difference in regression discontinuities design;
    All these keywords.

    JEL classification:

    • I12 - Health, Education, and Welfare - - Health - - - Health Behavior
    • I13 - Health, Education, and Welfare - - Health - - - Health Insurance, Public and Private
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health

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