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The mediating effect of morbidity on price and benefits in the context of consumer health insurance choice.

机译:在消费者健康保险选择的背景下,发病率对价格和收益的中介作用。

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摘要

This dissertation investigates how factors such as morbidity, out-of-pocket (OOP) premiums and benefits affect consumer choice of health insurance. Individual and family data from 12 large, fully insured employer groups were obtained from Blue Cross Blue Shield of Minnesota and merged with survey data. The employers included in this analysis offered only one managed care plan and one non-managed care plan from Blue Cross Blue Shield of Minnesota to their employees at open enrollment time in 1997 and 1998.; Logistic regression models were specified to quantify the relationships between morbidity, out-of-pocket premiums and choice of health insurance. Out-of-pocket premium elasticity results indicate that demand for health insurance tends to be price inelastic on average. These estimates decrease in absolute value as individual and family morbidity levels increase. I calculate that a {dollar}10 out-of-pocket premium increase will decrease the market share of the managed care plan by roughly 10 percentage points (i.e. from 30 percent to 20 percent) for individuals and 6 percentage points for families. Although the main effect for morbidity is not significantly related to choice of health insurance in this sample, price elasticity decreases as individual and family morbidity increase. Including an actuarial benefit factor in the models indicated that both individuals and family members were highly sensitive to changes in plan benefit richness. Benefit-related elasticity estimates tended to be greater than 1.0 among healthy individuals and increased by a factor of 3 as morbidity levels increased. Additionally, I calculate that a {dollar}10-equivalent benefit decrease will reduce the market share of the managed care plan by 30 percentage points among the sickest individuals and by about 15 percentage points for the sickest families.
机译:本文研究了发病率,自费(OOP)保费和福利等因素如何影响消费者对健康保险的选择。从明尼苏达州的蓝十字蓝盾公司获得了来自12个拥有充分保险的大型雇主集团的个人和家庭数据,并将其与调查数据合并。这项分析中包括的雇主在1997年和1998年开放招生时仅向明尼苏达州蓝十字蓝盾公司提供了一项管理式护理计划和一项非管理式护理计划。使用Logistic回归模型来量化发病率,自付费用和健康保险选择之间的关系。自付费用弹性结果表明,对健康保险的需求平均而言倾向于价格无弹性。这些估计的绝对值随着个人和家庭发病率水平的增加而降低。我计算出,个人自付保费增加10美元,将使托管式医疗计划的市场份额对于个人而言减少大约10个百分点(即从30%降至20%),对家庭而言降低6个百分点。尽管在本样本中发病率的主要影响与健康保险的选择没有显着相关,但是随着个体和家庭发病率的增加,价格弹性下降。在模型中包括精算利益因素表明,个人和家庭成员都对计划利益丰富度的变化高度敏感。在健康个体中,与利益相关的弹性估计值往往大于1.0,并且随着发病率水平的提高,其系数增加了3倍。此外,我计算得出,相当于减少10美元的福利将使有病患者在管理式医疗计划中的市场份额减少30个百分点,而对有病家庭则减少约15个百分点。

著录项

  • 作者

    Griffiths, Stephen Jon.;

  • 作者单位

    University of Minnesota.;

  • 授予单位 University of Minnesota.;
  • 学科 Health Sciences Public Health.; Health Sciences Health Care Management.
  • 学位 Ph.D.
  • 年度 2002
  • 页码 140 p.
  • 总页数 140
  • 原文格式 PDF
  • 正文语种 eng
  • 中图分类 预防医学、卫生学;预防医学、卫生学;
  • 关键词

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