Healthcare facility choice and user fee abolition: regression discontinuity in a multinomial choice setting

作者:Koch Steven F*; Racine Jeffrey S
来源:Journal of the Royal Statistical Society - Series A: Statistics in Society , 2016, 179(4): 927-950.
DOI:10.1111/rssa.12161

摘要

We apply parametric and non-parametric regression discontinuity methodology within a multinomial choice setting to examine the effect of public healthcare user fee abolition on health facility choice by using data from South Africa. The non-parametric model is found to outperform the parametric model both in and out of sample, while also delivering more plausible estimates of the effect of user fee abolition (i.e. the treatment effect'). In the parametric framework, treatment effects were relatively constantaround 10%and that increase was drawn equally from home care and private care. In contrast, in the non-parametric framework treatment effects were largest for large (and poor) families located further from health facilitiesapproximately 5%. More plausibly, the positive treatment effect was drawn primarily from home care, suggesting that the policy favoured children living in poorer conditions, as those children received at least some minimum level of professional healthcare after the policy was implemented.

  • 出版日期2016-10