Journal of Public Economics · 2022 · Henry Downes、David C. Phillips、James X. Sullivan
中文摘要
向刚刚经历收入冲击的人提供财政援助是否会影响其医疗服务利用？为回答这一问题，我们考察了以下情境中的医疗结果：因收入冲击而面临无家可归风险的人被准随机地提供或拒绝转介至财政援助。在芝加哥无家可归预防呼叫中心（HPCC）经筛查符合援助资格的求助者中，部分人因资金可获得性变化而被拒绝援助。在给定某些可观测特征的条件下，资金可获得性对求助者而言如同随机分配。我们将求助者与医疗服务利用记录相链接，并观测其住院和急诊就诊情况。我们发现，转介至财政援助对总体医疗服务利用几乎没有影响——我们可以排除总利用率增加超过基准率的7%以及减少超过4%的情况。这种零效应部分可由以下事实解释：收入冲击并未显著改变未接受援助者的总体医疗服务利用，这表明这些个体能够通过其他方式针对这些冲击为其健康和医疗服务需求提供保险。
Abstract
Does providing financial assistance to people who have just experienced an income shock affect their healthcare use? To address this question, we examine healthcare outcomes in a setting where people at risk of homelessness due to an income shock were offered or denied referral to financial assistance quasi-randomly. Among callers who have been screened as eligible for assistance at Chicago’s Homelessness Prevention Call Center (HPCC), some are denied assistance because the availability of funding varies. Conditional on some observable characteristics, funding availability is as-good-as-randomly assigned to callers. We link callers to healthcare utilization records and observe their inpatient hospital stays and emergency department visits. We find that referral to financial assistance has little effect on overall healthcare use–we can reject increases in total utilization greater than 7% of the base rate and decreases of more than 4%. This null effect can be explained, in part, by the fact that the income shock does not significantly change overall healthcare use among those not receiving assistance, suggesting that these individuals can insure health and healthcare demand against these shocks in other ways.