“Doctor my eyes”: A natural experiment on the demand for eye care services

Dickey, Heather; Ikenwilo, Divine; Norwood, Patricia; Watson, Verity; Zangelidis, Alexandros

doi:10.1016/j.socscimed.2015.12.037

Cited by 2 publications

(2 citation statements)

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“…One concern is that the use of Out of Pocket (OOP) may lead to suboptimal use of essential eye services and medications, particularly among the poor (4). The degree of cost sharing between individuals and third-party payer affects preventive service use (5). There is evidence that confirmed the existing of a considerable unmet need for ophthalmic services in Iran (6–8).…”

Section: Introductionmentioning

confidence: 99%

Ophthalmic Care Utilization and Out-of-Pocket Expenditure in Iran: Kurdistan Eye Health and Economics Survey-2015

Mohammadi¹,

Alinia²,

Ghaderi³

et al. 2020

ijph

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Background: Due to lack of information about ophthalmic economics in Iran, health policy makers unable to distribute resources optimally in terms of efficiency and equity. Therefore, we estimated the total and eye care utilization, out-of-pocket expenditures, and its association with social determinants of health in Iran in 2015. Methods: A multi-stage population-based, cross-sectional study in a random sample aged 50 yr or older in Kurdistan Province, Northwest Iran was used. The utilization rate of eye and general health care and related out-of-pocket expenditures was estimated during the recent last six months. To find the association between social factors and care out-of-pocket expenditures, we used a Heckman two-step regression model. Results: About 81% and 37% of participants were utilized the health and ophthalmic services, respectively. Statistically significant lower ophthalmic utilization rates were observed among men, middle-aged population, illiterate participants, rural residents, daily-paid workers, and the poorest participants. The average of vision and total health-related out-of-pocket expenditures among those used these services have estimated as US$43.7 (SE: 2.6) and US$439.9 (SE: 22.8), respectively. The highest (US$ 396.6) and lowest (US$ 10.4) ophthalmic out-of-pocket costs were related to patients with Glaucoma and Central Nervous System abnormalities, respectively. Multivariate analyses confirmed an unequal probability of having the ophthalmic out-of-pocket expenditures among different subgroups especially in favor of females, older, and those with more severe visual impairment. Conclusion: Ophthalmic disorders reconstituted about 10% of all health services OOP expenditures on average among individuals older than 50 yr.

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Section: Introductionmentioning

confidence: 99%

Ophthalmic Care Utilization and Out-of-Pocket Expenditure in Iran: Kurdistan Eye Health and Economics Survey-2015

Mohammadi¹,

Alinia²,

Ghaderi³

et al. 2020

ijph

View full text Add to dashboard Cite

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“…In contrast to the situation in the United States (US), where the literature on the link between health insurance and healthcare consumption is especially rich, following the RAND Health Insurance Experiment (HIE) [8] and the more recent Oregon Health Insurance Experiment (OHIE) [9], studies on this topic from Europe are not so common; where, why and how much to pay for health coverage are not the same. There are mainly studies on deductibles from Switzerland [10][11][12] and some others on recent variations in copayments, often for visits to primary care physicians, from Ireland [13], the Netherlands [14], Norway [15,16], Portugal [17], Scotland [18], Spain [19,20] and Sweden [21]. This lack of research is probably because in most European countries healthcare is either provided through the national health service (NHS), such as in the United Kingdom, or covered by compulsory standard health insurance, whether managed publicly (e.g., France, Germany) or by private companies (e.g., the Netherlands, Switzerland).…”

Section: Introductionmentioning

confidence: 99%

Healthcare consumption after a change in health insurance coverage: a French quasi-natural experiment

2020

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Background: Compared with the number of studies performed in the United States, few studies have been conducted on the link between health insurance and healthcare consumption in Europe, likely because most European countries have compulsory national health insurance (NHI) or a national health service (NHS). Recently, a major French private insurer, offering voluntary complementary coverage in addition to the compulsory NHI, replaced its single standard package with a range of offers from basic coverage (BC) to extended coverage (EC), providing a quasi-natural experiment to test theoretical assumptions about consumption patterns. Methods: Reimbursement claim data from 85,541 insurees were analysed from 2009 to 2018. Insurees who opted for EC were matched to those still covered by BC with similar characteristics. Difference-indifferences (DiD) models were used to compare both the monetary value and physical quantities of healthcare consumption before and after the change in coverage. Results: As expected, the DiD models revealed a strongly significant, though transitory (mainly during the first year), increase after the change in coverage for EC insurees, particularly for costly care such as dental prostheses and spectacles. Surprisingly, consumption seemed to precede the change in coverage, suggesting that one possible determinant of opting for more coverage may be previous unplanned expenses. Conclusion: Both catching-up behaviour and moral hazard are likely to play a role in the observed increase in healthcare consumption.

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“Doctor my eyes”: A natural experiment on the demand for eye care services

Cited by 2 publications

References 46 publications

Ophthalmic Care Utilization and Out-of-Pocket Expenditure in Iran: Kurdistan Eye Health and Economics Survey-2015

Ophthalmic Care Utilization and Out-of-Pocket Expenditure in Iran: Kurdistan Eye Health and Economics Survey-2015

Healthcare consumption after a change in health insurance coverage: a French quasi-natural experiment

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