Arbeitspapier

Copayments for ambulatory care in Germany: A natural experiment using a difference-in-difference approach

In response to increasing health expenditures and a high number of physician visits, the German government introduced a copayment for ambulatory care in 2004 for individuals with statutory health insurance (SHI). Because persons with private insurance were exempt from the copayments, this health care reform can be regarded as a natural experiment. We used a difference-in-difference approach to examine whether the new copayment effectively reduced the overall demand for physician visits and to explore whether it acted as a deterrent to vulnerable groups, such as those with low income or chronic conditions. We found that there was no significant reduction in the number of physician visits among SHI members compared to our control group. At the same time, we did not observe a deterrent effect among vulnerable individuals. Thus, the copayment has failed to reduce the demand for physician visits. It is likely that this result is due to the design of the copayment scheme, as the copayment is low and is paid only for the first physician visit per quarter.

Sprache
Englisch

Erschienen in
Series: DIW Discussion Papers ; No. 777

Klassifikation
Wirtschaft
Estimation: General
Health: Government Policy; Regulation; Public Health
Nonprofit Institutions; NGOs; Social Entrepreneurship
Thema
copayments
ambulatory care
difference-in-difference
count data
zero-inflated-model
Patienten
Konsumentenverhalten
Selbstbeteiligung (Versicherung)
Gesetzliche Krankenversicherung
Ärzte
Wirtschaftspolitische Wirkungsanalyse
Deutschland

Ereignis
Geistige Schöpfung
(wer)
Schreyögg, Jonas
Grabka, Markus M.
Ereignis
Veröffentlichung
(wer)
Deutsches Institut für Wirtschaftsforschung (DIW)
(wo)
Berlin
(wann)
2008

Handle
Letzte Aktualisierung
10.03.2025, 11:44 MEZ

Datenpartner

Dieses Objekt wird bereitgestellt von:
ZBW - Deutsche Zentralbibliothek für Wirtschaftswissenschaften - Leibniz-Informationszentrum Wirtschaft. Bei Fragen zum Objekt wenden Sie sich bitte an den Datenpartner.

Objekttyp

  • Arbeitspapier

Beteiligte

  • Schreyögg, Jonas
  • Grabka, Markus M.
  • Deutsches Institut für Wirtschaftsforschung (DIW)

Entstanden

  • 2008

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