This paper measures consumer responsiveness to cost sharing in healthcare using a regression discontinuity design. I use a novel and detailed claims-level dataset from the Colombian healthcare market, where the government exogenously determines a tier system for coinsurance rates and copays based on the enrollee's monthly income. I find that patients exposed to higher coinsurance rates demand fewer services relative to patients facing lower cost sharing. This reduction holds for both discretionary and preventive services. Lower utilization translates into lower costs, despite evidence that patients facing higher prices do not substitute away from more expensive providers.

中文翻译：

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受监管市场中的成本分摊和卫生服务需求

本文使用回归不连续性设计衡量消费者对医疗保健成本分摊的反应。我使用了来自哥伦比亚医疗保健市场的一个新颖而详细的索赔级别数据集，其中政府根据参保人的月收入外生地确定了共同保险费率和共付额的等级系统。我发现，与面临较低分摊费用的患者相比，接受较高共同保险费率的患者需要较少的服务。这种减少适用于酌情服务和预防服务。尽管有证据表明面临更高价格的患者并不能替代更昂贵的供应商，但较低的利用率会转化为较低的成本。