Once bitten, twice shy? Lessons learned from an experiment to liberalize price regulations for dental care

Autor: Frank Gabel, Stefan Listl, Olivier Kalmus, Onno van der Galiën, Anna-Lena Trescher
Rok vydání: 2019
Předmět:
Databases
Factual
Economics
Econometrics and Finance (miscellaneous)
Context (language use)
Oral care
Quasi-experimental design
Healthcare improvement science Radboud Institute for Health Sciences [Radboudumc 18]
Type of service
03 medical and health sciences
All institutes and research themes of the Radboud University Medical Center
0302 clinical medicine
Information asymmetry
Humans
030212 general & internal medicine
Free market
Dental Care
health care economics and organizations
Netherlands
Service (business)
Original Paper
Price liberalization
Health economics
I18
Liberalization
I11
Prevention
Health Policy
Politics
030206 dentistry
Patient Acceptance of Health Care
3. Good health
Health Care Reform
Costs and Cost Analysis
Demographic economics
Business
Models
Econometric
Quasi-experiment
Zdroj: European Journal of Health Economics, 21, 3, pp. 425-436
European Journal of Health Economics, 21, 425-436
The European Journal of Health Economics
ISSN: 1618-7601
1618-7598
DOI: 10.1007/s10198-019-01145-z
Popis: In 2012, The Netherlands established the so-called “free market experiment”, which allowed providers of dental care to set the prices for their dental services themselves. The introduction of market mechanisms is intended to improve the quality of care and to contribute to cost containment, but increasing health expenditures for citizens have been observed in this context. Using large-volume health insurance claims data and exploiting the 2012 experiment in Dutch dental care, we identified the effects of a liberalization of service prices. Using pooled regression with individual fixed effects, we analyzed changes in utilization patterns of prevention-oriented dental services in response to the experiment as well as the elasticities in demand in response to variations in out-of-pocket (OOP) prices. We found substantial increases in prices and patients’ OOP contributions for dental services following the liberalization with differences in increases between types of services. In response to the experiment, the proportion of treatment sessions containing preventive-oriented services decreased significantly by 3.4% among adults and by 5.3% for children and adolescents. Estimates of short-run price elasticities of demand for different services point towards differences in price sensitivity. One potential explanation for the observed variations in prices and utilization could be different extents of asymmetric information for first-stage and follow-on services. Price liberalization seems to have affected the composition of treatment sessions towards a decreasing use of preventive services, suggesting a shift in the reason for seeing a dental care provider from a regular-preventive perspective to a symptom-based restorative approach. Electronic supplementary material The online version of this article (10.1007/s10198-019-01145-z) contains supplementary material, which is available to authorized users.
Databáze: OpenAIRE
Externí odkaz: