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

Péter Elek (), Tamás Molnár () and Balázs Váradi
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Péter Elek: Eötvös Loránd University (ELTE)
Tamás Molnár: Budapest Institute for Policy Analysis

The European Journal of Health Economics, 2019, vol. 20, issue 6, No 3, 817 pages

Abstract: Abstract In 2010–2012, new outpatient service locations were established in poor Hungarian micro-regions. 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 (search for similar items in EconPapers)
JEL-codes: C23 C26 I10 (search for similar items in EconPapers)
Date: 2019
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DOI: 10.1007/s10198-019-01043-4

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