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Article: Measuring moral hazard and adverse selection by propensity scoring in the mixed health care economy of Hong Kong

TitleMeasuring moral hazard and adverse selection by propensity scoring in the mixed health care economy of Hong Kong
Authors
KeywordsHealth insurance
Health services
Hong Kong
Moral hazard
Issue Date2010
PublisherElsevier Ireland Ltd. The Journal's web site is located at http://www.elsevier.com/locate/healthpol
Citation
Health Policy, 2010, v. 95 n. 1, p. 24-35 How to Cite?
AbstractObjectives: To evaluate the presence of moral hazard, adjusted for the propensity to have self-purchased insurance policies, employer-based medical benefits, and welfare-associated medical benefits in Hong Kong. Methods: Based on 2005 population survey, we used logistic regression and zero-truncated negative binomial/Poisson regressions to assess the presence of moral hazard by comparing inpatient and outpatient utilization between insured and uninsured individuals. We fitted each enabling factor specific to the type of service covered, and adjusted for predisposing socioeconomic and demographic factors. We used a propensity score approach to account for potential adverse selection. Results: Employment-based benefits coverage was associated with increased access and intensity of use for both inpatient and outpatient care, except for public hospital use. Similarly, welfare-based coverage had comparable effect sizes as employment-based schemes, except for the total number of public ambulatory episodes. Self-purchased insurance facilitated access but did not apparently induce greater demand of services among ever users. Nevertheless, there was no evidence of moral hazard in public hospital use. Conclusions: Our findings suggest that employment-based benefits coverage lead to the greatest degree of moral hazard in Hong Kong. Future studies should focus on confirming these observational findings using a randomized design. © 2009 Elsevier Ireland Ltd. All rights reserved.
Persistent Identifierhttp://hdl.handle.net/10722/86504
ISSN
2015 Impact Factor: 2.035
2012 SCImago Journal Rankings: 0.733
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorWong, IOLen_HK
dc.contributor.authorLindner, MJen_HK
dc.contributor.authorCowling, BJen_HK
dc.contributor.authorLau, EHYen_HK
dc.contributor.authorLo, SVen_HK
dc.contributor.authorLeung, GMen_HK
dc.date.accessioned2010-09-06T09:17:52Z-
dc.date.available2010-09-06T09:17:52Z-
dc.date.issued2010en_HK
dc.identifier.citationHealth Policy, 2010, v. 95 n. 1, p. 24-35en_HK
dc.identifier.issn0168-8510en_HK
dc.identifier.urihttp://hdl.handle.net/10722/86504-
dc.description.abstractObjectives: To evaluate the presence of moral hazard, adjusted for the propensity to have self-purchased insurance policies, employer-based medical benefits, and welfare-associated medical benefits in Hong Kong. Methods: Based on 2005 population survey, we used logistic regression and zero-truncated negative binomial/Poisson regressions to assess the presence of moral hazard by comparing inpatient and outpatient utilization between insured and uninsured individuals. We fitted each enabling factor specific to the type of service covered, and adjusted for predisposing socioeconomic and demographic factors. We used a propensity score approach to account for potential adverse selection. Results: Employment-based benefits coverage was associated with increased access and intensity of use for both inpatient and outpatient care, except for public hospital use. Similarly, welfare-based coverage had comparable effect sizes as employment-based schemes, except for the total number of public ambulatory episodes. Self-purchased insurance facilitated access but did not apparently induce greater demand of services among ever users. Nevertheless, there was no evidence of moral hazard in public hospital use. Conclusions: Our findings suggest that employment-based benefits coverage lead to the greatest degree of moral hazard in Hong Kong. Future studies should focus on confirming these observational findings using a randomized design. © 2009 Elsevier Ireland Ltd. All rights reserved.en_HK
dc.languageengen_HK
dc.publisherElsevier Ireland Ltd. The Journal's web site is located at http://www.elsevier.com/locate/healthpolen_HK
dc.relation.ispartofHealth Policyen_HK
dc.rightsHealth Policy. Copyright © Elsevier Ireland Ltd.en_HK
dc.subjectHealth insuranceen_HK
dc.subjectHealth servicesen_HK
dc.subjectHong Kongen_HK
dc.subjectMoral hazarden_HK
dc.subject.meshHealth Benefit Plans, Employee - economics - statistics & numerical data-
dc.subject.meshHealth Services Needs and Demand-
dc.subject.meshInsurance, Health - economics - statistics & numerical data-
dc.subject.meshMorals-
dc.subject.meshSocial Welfare - economics - statistics & numerical data-
dc.titleMeasuring moral hazard and adverse selection by propensity scoring in the mixed health care economy of Hong Kongen_HK
dc.typeArticleen_HK
dc.identifier.openurlhttp://library.hku.hk:4550/resserv?sid=HKU:IR&issn=0168-8510&volume=95&spage=24&epage=35&date=2010&atitle=Measuring+moral+hazard+and+adverse+selection+by+propensity+scoring+in+the+mixed+health+care+economy+of+Hong+Kongen_HK
dc.identifier.emailWong, IOL: iolwong@hku.hken_HK
dc.identifier.emailCowling, BJ: bcowling@hku.hken_HK
dc.identifier.emailLau, EHY: ehylau@hku.hken_HK
dc.identifier.emailLeung, GM: gmleung@hkucc.hku.hken_HK
dc.identifier.authorityWong, IOL=rp01806en_HK
dc.identifier.authorityCowling, BJ=rp01326en_HK
dc.identifier.authorityLau, EHY=rp01349en_HK
dc.identifier.authorityLeung, GM=rp00460en_HK
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.doi10.1016/j.healthpol.2009.10.006en_HK
dc.identifier.pmid19931206-
dc.identifier.scopuseid_2-s2.0-77349094007en_HK
dc.identifier.hkuros169088en_HK
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-77349094007&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume95en_HK
dc.identifier.issue1en_HK
dc.identifier.spage24en_HK
dc.identifier.epage35en_HK
dc.identifier.isiWOS:000276594600003-
dc.publisher.placeIrelanden_HK
dc.identifier.scopusauthoridWong, IOL=7102513940en_HK
dc.identifier.scopusauthoridLindner, MJ=36137470900en_HK
dc.identifier.scopusauthoridCowling, BJ=8644765500en_HK
dc.identifier.scopusauthoridLau, EHY=7103086074en_HK
dc.identifier.scopusauthoridLo, SV=8426498400en_HK
dc.identifier.scopusauthoridLeung, GM=7007159841en_HK
dc.identifier.citeulike6188343-

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