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

Christine Sevilla-Dedieu, Nathalie Billaudeau and Alain Paraponaris
Additional contact information
Christine Sevilla-Dedieu: Fondation MGEN pour la santé publique
Nathalie Billaudeau: Fondation MGEN pour la santé publique

Post-Print from HAL

Abstract: Background: Compared to 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 strong 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 increase observed in healthcare consumption.

Keywords: Complementary health insurance; Moral hazard; Healthcare consumption; Longitudinal data; Exact matching; Difference-in-differences (search for similar items in EconPapers)
Date: 2020-06
New Economics Papers: this item is included in nep-eur and nep-ias
Note: View the original document on HAL open archive server: https://amu.hal.science/hal-02879319
References: View references in EconPapers View complete reference list from CitEc
Citations: View citations in EconPapers (2)

Published in Health Economics Review, 2020, 10 (1), pp.17. ⟨10.1186/s13561-020-00275-y⟩

Downloads: (external link)
https://amu.hal.science/hal-02879319/document (application/pdf)

Related works:
Journal Article: Healthcare consumption after a change in health insurance coverage: a French quasi-natural experiment (2020)
This item may be available elsewhere in EconPapers: Search for items with the same title.

Export reference: BibTeX RIS (EndNote, ProCite, RefMan) HTML/Text

Persistent link: https://EconPapers.repec.org/RePEc:hal:journl:hal-02879319

DOI: 10.1186/s13561-020-00275-y

Access Statistics for this paper

More papers in Post-Print from HAL
Bibliographic data for series maintained by CCSD ().