The Effectiveness of Health Screening

Abstract

Standard-Nutzungsbedingungen:Die Dokumente auf EconStor dürfen zu eigenen wissenschaftlichen Zwecken und zum Privatgebrauch gespeichert und kopiert werden.Sie dürfen die Dokumente nicht für öffentliche oder kommerzielle Zwecke vervielfältigen, öffentlich ausstellen, öffentlich zugänglich machen, vertreiben oder anderweitig nutzen.Sofern die Verfasser die Dokumente unter Open-Content-Lizenzen (insbesondere CC-Lizenzen) zur Verfügung gestellt haben sollten, gelten abweichend von diesen Nutzungsbedingungen die in der dort genannten Lizenz gewährten Nutzungsrechte. Terms of use: Documents in Forthcoming in Health EconomicsMarch 31, 2014 (First version: January 2012) AbstractUsing a matched insurant-general practitioner panel data set, we estimate the effect of a general health screening program on individuals' health status and health care cost. To account for selection into treatment we use regional variation in the intensity of exposure to supply-determined screening recommendations as an instrumental variable. We find that screening participation increases in-and outpatient health care cost up to two years after treatment substantially. In the medium-run, we find cost savings in the outpatient sector whereas, in the long-run, no statistically significant effects of screening on either health care cost component can be discerned. In sum, screening participation increases health care cost. Given that we do not find any statistically significant effect of screening participation on insurants' health status (at any point in time), we do not recommend a general health screening program. However, given that we find some evidence for cost-saving potential for the sub-sample of younger insurants, we suggest more targeted screening programs.

Exploring variations in health‐care expenditures—What is the role of practice styles?

“…In addition, we use the aggregate number of days of absence due to sickness, days of hospitalization, drug expenses, and preventive screening expenditures as outcomes. The latter is an interesting outcome, because both anecdotal evidence and earlier research (Hackl, Halla, Hummer, & Pruckner, 2015) suggest that much of the variation in screening participation is induced by supply heterogeneities. Thus, it provides an interesting benchmark for the other outcomes.…”

“…Percentage calculations that also consider the covariance terms in Equation (2) can be found inTable S3. 10 See alsoHackl et al (2015), who use the variation in GPs' screening recommendations in Upper Austria as an instrument for screening participation, and find a substantial first stage effect. 11Figure S2gshows the distribution of the predicted GP fixed effects graphically.…”

The company you keep: health behavior among work peers

“…Each estimate in columns (1), (5), and (9) comes from a separate regression and shows the effect of peer behavior on individual screening participation. Columns (3), (7), and (9) show the mean of the dependent variable, and columns (4), (8), and (12) show the number of observations. All regressions control for past healthcare utilization (screening participation, outpatient expenditure, days in hospital), wage, age, place of residence, job type, business sector, firm location, firm size, and year of job move.…”

“…Separate social insurance funds offer health insurance for specific occupational groups such as farmers, civil servants, and selfemployed persons 3. See [3, § 132b] for the general goals, and Main Association of Austrian Social Security[19] and Hackl et al[12] for details of the screening program.…”

Payment models in primary health care: A driver of the quantity and quality of medical laboratory utilization

“…Not ordering useful tests is also problematic, but the data available cannot identify this. A related economic literature addresses medical screening and imaging (e.g., Aas, 2009;Abaluck, Agha, Kabrhel, Raja, & Venkatesh, 2016;Hackl, Halla, Hummer, & Pruckner, 2015). 3 For the United States, see http://www.choosingwisely.org/, and for Canada, see http://www.choosingwiselycanada.org/.…”