Homepage > Research abstracts > The implications of the changes in eligibility for medical fees exemption, on community and hospital services usage, and on population health: a retrospective study, 2003-2015
The implications of the changes in eligibility for medical fees exemption, on community and hospital services usage, and on population health: a retrospective study, 2003-2015
Researchers: Esti-Engelchin-Nissan1, Kokia Ehud1, Ninio Dudi2, Ardanstni Tamar2
- The Ramat Gan Academic College
- Maccabi Healthcare Services
Background: In fully competitive markets, the optimal point of consumption is the point at which the marginal expenditure of the producer meets the marginal benefit of consumers. In the health markets, where consumers do not pay for the services provided (the payments being paid by a third party), their tendency to consume health services rises and therefore this peak is not attainable as a free market. The premium payment was intended for preventing the misuse of health care services. Fearing that these payments may prevent low socioeconomic populations from obtaining medical services, a decision was made to exempt them from these payments. However, in 2003, it was decided to cancel the deductible exemptions for three different population sectors.
Objectives: The objective of this study is twofold: to estimate the consequences arising from both the canceled exemption in visits to the doctor and the changes in the individual's health status.
Method: Members of the Maccabi health care plan were assessed during a fifteen-year period. Comparisons of average visits to the doctor were analyzed by means of the T-test. The generalized Estimating Equation was also used in the multivariate model on account of recurrent patient measurements. The comparisons in cost were performed by means of ANOVA and Post Hoc Tests.
Findings: A decrease in the number of uses for a primary physician visit was noticed among the children group while the most significant decline occurred in the group that canceled the exemption from payment of fees. A lower decline occurred in the control groups. In the group of children up to the age of 18, there were significant increases.
Conclusions: The findings demonstrate that the cancellation of the exemption from the fee has impacted the amount of service consumption.
Recommendations: Canceling the exemption from medical fees for needy population groups creates social gaps and promotes inequality.
Research number: R/71/2016
Research end date: 11/2018