Department of Economics and Business Economics

Patient cost-sharing, socioeconomic status, and children’s health care utilization

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This paper estimates the effect of cost-sharing on the demand for children’s and adolescents’ use of medical care. We use a large population-wide registry dataset including detailed information on contacts with the health care system as well as family income. Two different estimation strategies are used: regression discontinuity design exploiting age thresholds above which fees are charged, and difference- in-differences models exploiting policy changes. We also estimate combined regression discontinuity difference-in-differences models that take into account discontinuities around age thresholds caused by factors other than cost-sharing. We find that when care is free of charge, individuals increase their number of doctor visits by 5–10%. Effects are similar in middle childhood and adolescence, and are driven by those from low-income families. The differences across income groups cannot be explained by other factors that correlate with income, such as maternal education.
Original languageEnglish
JournalJournal of Health Economics
Volume59
IssueMay
Pages (from-to)109-124
ISSN0167-6296
DOIs
Publication statusPublished - 2018

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