The closer the better: does better access to outpatient care prevent hospitalization?

Péter Elek, Tamas Molnar () and Balázs Váradi
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Tamas Molnar: Budapest Institute for Policy Analysis, Budapest, Hungary

No 1808, CERS-IE WORKING PAPERS from Institute of Economics, Centre for Economic and Regional Studies

Abstract: In 2010-2012 new outpatient service locations were established in poor Hungarian microregions. We exploit this quasi-experiment to estimate the extent of substitution between outpatient and inpatient care. Fixed-effects Poisson models on individual-level panel data for years 2008-2015 show that the number of outpatient visits increased by 19% and the number of inpatient stays decreased by 1.6% as a result, driven by a marked reduction of potentially avoidable hospitalization (PAH) (5%). In our dynamic specification, PAH effects occur in the year after the treatment, whereas non-PAH only decreases with a multi-year lag. The instrumental variable estimates suggest that a one euro increase in outpatient care expenditures produces a 0.6 euro decrease in inpatient care expenditures. Our results (1) strengthen the claim that bringing outpatient care closer to a previously underserved population yields considerable health benefits, and (2) suggest that there is a strong substitution element between outpatient and inpatient care.

Keywords: Administrative panel data; Inpatient care; Outpatient care; Potentially avoidable hospitalization; Quasi-experiment; Substitution effect (search for similar items in EconPapers)
JEL-codes: C23 C26 I10 (search for similar items in EconPapers)
Pages: 43 pages
Date: 2018-04
New Economics Papers: this item is included in nep-hea and nep-tra
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Journal Article: The closer the better: does better access to outpatient care prevent hospitalization? (2019)
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Persistent link: https://EconPapers.repec.org/RePEc:has:discpr:1808

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