Econ Papers Daily / 期刊论文
广告是否扩大了医院服务市场？来自Medicare的证据
Does advertising expand the market for hospital services? Evidence from Medicare
摘要
Direct-to-consumer advertising is pervasive in US healthcare markets, but little evidence exists on the effects of advertising by hospitals, second only to drug manufacturers in medical marketing. Advertising may help facilities increase market share by stealing existing patients, expanding the market for hospital care, or both. Regardless, it has important public finance implications due to the large sums of taxpayer funds spent by federal and state governments to subsidize hospital operations and finance care through public insurance programs. This paper provides the first causal evidence on the market expansion effects of hospital advertising. To obtain causal estimates, we leverage the fact that spikes in political advertising significantly crowd out hospital advertising in the same market, motivating an instrumental variables design. Using claims data on the universe of Traditional Medicare beneficiaries, we find that advertising expands aggregate patient volume and spending on inpatient care - though to a modest degree (implied elasticities are 0.06 and 0.05, respectively). Although the overall effect of advertising on hospital outpatient care is small and imprecise, for-profit hospitals obtain higher outpatient Medicare volume and revenue.
中文摘要
直接面向消费者的广告在美国医疗保健市场无处不在，但关于医院广告效果的证据却很少，而医院在医疗营销中的支出仅次于药品制造商。广告可能通过吸引现有患者、扩大医院护理市场或两者兼而有之，帮助医疗机构增加市场份额。无论如何，由于联邦和州政府花费大量纳税人资金补贴医院运营并通过公共保险项目资助医疗护理，这具有重要的公共财政影响。本文提供了关于医院广告市场扩张效应的首个因果证据。为获得因果估计，我们利用政治广告的激增会显著挤占同一市场中医院广告这一事实，构建工具变量设计。使用覆盖传统 Medicare 全体受益人的理赔数据，我们发现广告扩大了总体患者量和住院护理支出——尽管程度有限（隐含弹性分别为 0.06 和 0.05）。尽管广告对医院门诊护理的总体效应较小且不精确，但营利性医院获得了更高的门诊 Medicare 量和收入。