医疗服务地理差异的来源：来自患者迁移的证据*

中文摘要

我们采用利用Medicare患者迁移来区分需求和供给因素作用的实证策略，研究美国医疗服务利用地理差异的驱动因素。我们的方法能够考虑到由可观测和不可观测的患者特征所驱动的需求差异。在我们的65岁以上Medicare受益人样本中，我们发现，医疗服务利用地理差异的40%–50%可归因于需求侧因素，包括健康状况和偏好，其余则归因于特定地区的供给因素。JEL：H51、I1、I11。

Abstract

We study the drivers of geographic variation in US health care utilization, using an empirical strategy that exploits migration of Medicare patients to separate the role of demand and supply factors. Our approach allows us to account for demand differences driven by both observable and unobservable patient characteristics. Within our sample of over-65 Medicare beneficiaries, we find that 40-50 percent of geographic variation in utilization is attributable to demand-side factors, including health and preferences, with the remainder due to place-specific supply factors. JEL: H51, I1, I11.