What are the effects of cost sharing on health care utilization and health outcomes? While tremendous progress has been made on the answer to this question there remain some noticeable gaps in this literature. Most importantly more studies are necessary to understand how cost sharing affects the treatment of non- elderly adults and outcomes related to chronic diseases. This study exploits knowledge of how the Chilean government assigns individuals to health insurance plans in the public health insurance program in Chile (FONASA) to understand how cost-sharing affects health insurance utilization and health outcomes for adults in the Chilean health insurance system. FONASA assigns individuals from all across the adult age distribution into health insurance plans with varying levels of cost- sharing (0%, 10% and 20%) based on individual wage and household size. Using a regression discontinuity research design we propose to exploit this plan assignment procedure and aim to estimate causal estimates of the effects of cost sharing on health care utilization and health outcomes. This study will examine the effects on a variety of health utilization and health outcomes measures including physician, hospital, emergency room visits and asthma, hypertension, diabetes and depression detection.
Understanding the impact of cost sharing on health care utilization and health outcomes is central to understanding the expected benefits and costs of universal health insurance. However, there remain some large gaps in this literature. We propose to use data from the Chilean public health insurance system to understand the effects of cost sharing on health utilization and health outcomes for low-income adults from both the non-elderly and elderly populations. Results from this study will also provide evidence on the effects of cost sharing on chronic disease detection and treatment.
