论文标题：Delisting eye examinations from public health insurance: Empiricalevidence from Canada regarding impacts on patients and providers

　　发表时间：202005

　　论文所有作者：Wang Chao, Arthur Sweetman

　　期刊名及所属分类：Health Policy(国际C)

　　英文摘要：This paper examines the impacts of delisting routine eye exam services on patient eye care utilization and on providers' labour market outcomes in a public healthcare system. Provincial governments in Canada started to de-insure routine eye examinations from the basket of publicly insured healthcare services in the early 1990s. We explore these policy changes across Canadian provinces to estimate the impacts of delisting from the supply- and demand-sides. Demand side analysis suggests that, on average, for the working age population delisting decreased the probability of using eye care. However, the number of visits among those who continued to use eye care services did not change. Additionally, the delisting may have had unintended consequences by causing a large negative impact among low-income individuals, and there is suggestive evidence of a positive spillover on utilization by publicly-funded patients over age 64. On the supply side, using Canadian census data we find that delisting eye exams decreased optometrists' weekly work hours, raised their annual work weeks and had little effect on their income.

　　中文摘要：本文探讨了在公共医疗系统中，将常规眼科检查服务撤下对患者眼科保健利用和供应商劳动力市场结果的影响。20世纪90年代初，加拿大省政府开始将常规眼科检查从公共保险医疗服务的保险篮子中剔除。我们探讨了加拿大各省的这些政策变化，以评估从供应和需求方面退市的影响。需求方分析表明，平均而言，对于劳动年龄人口退市降低了使用眼部护理的概率。然而，那些继续使用眼科保健服务的患者的就诊次数没有变化。此外，由于在低收入人群中造成了巨大的负面影响，从名单上除名可能会产生意想不到的后果，而且有证据表明，公共资助的患者超过年龄使用药物会产生积极的溢出效应. 在供应方面，利用加拿大人口普查的数据，我们发现删除眼科检查减少了验光师的周工作时间，提高了他们的年工作周，对他们的收入影响很小。