Please use this identifier to cite or link to this item: https://hdl.handle.net/10419/222021 
Year of Publication: 
2018
Series/Report no.: 
IEHAS Discussion Papers No. MT-DP - 2018/8
Publisher: 
Hungarian Academy of Sciences, Institute of Economics, Budapest
Abstract: 
In 2010-2012 new outpatient service locations were established in poor Hungarian microregions. We exploit this quasi-experiment to estimate the extent of substitution between outpatient and inpatient care. Fixed-effects Poisson models on individual-level panel data for years 2008-2015 show that the number of outpatient visits increased by 19% and the number of inpatient stays decreased by 1.6% as a result, driven by a marked reduction of potentially avoidable hospitalization (PAH) (5%). In our dynamic specification, PAH effects occur in the year after the treatment, whereas non-PAH only decreases with a multi-year lag. The instrumental variable estimates suggest that a one euro increase in outpatient care expenditures produces a 0.6 euro decrease in inpatient care expenditures. Our results (1) strengthen the claim that bringing outpatient care closer to a previously underserved population yields considerable health benefits, and (2) suggest that there is a strong substitution element between outpatient and inpatient care.
Subjects: 
Administrative panel data
Inpatient care
Outpatient care
Potentially avoidable hospitalization
Quasi-experiment
Substitution effect
JEL: 
C23
C26
I10
Document Type: 
Working Paper

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