Skip to main content

Use of Experiments in Health Care

  • Reference work entry
  • First Online:
  • 29 Accesses

Abstract

Two of the best known randomised trials in health economics are described in detail in this chapter: the RAND Health Insurance Experiment and the Oregon Health Insurance Experiment. The RAND Experiment randomised participants to health insurance plans that varied the cost of care from free care at one extreme to an approximation of a large deductible at the other. Those on the free care plan increased their use of services by about 30% relative to those on the large deductible plan. For the average participant there appeared to be little or no effect on health outcomes from this change in use. Among the poor with hypertension (high blood pressure), however, blood pressure was better controlled on the free care plan, which projected to about a 10% decrease in the risk of mortality. The Oregon Experiment randomised its participants to Medicaid or to remaining uninsured; those with Medicaid insurance used more services and suffered less from depression.

This is a preview of subscription content, log in via an institution.

Buying options

Chapter
USD   29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD   6,499.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Hardcover Book
USD   8,499.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Learn about institutional subscriptions

Bibliography

  • Ansah, E.K., S. Narh-Bana, S. Asiamah, et al. 2009. Effect of removing direct payment for health care on utilisation and health outcomes in Ghanaian children: A randomised controlled trial. PLoS Medicine 6(1): 48–57.

    Article  Google Scholar 

  • Aron-Dine, A., L. Einav, and A. Finkelstein. 2013. The RAND Health Insurance Experiment, three decades later. Journal of Economic Perspectives 27(1): 197–222.

    Article  Google Scholar 

  • Arrow, K.J. 1963. Uncertainty and the welfare economics of medical care. American Economic Review 53(5): 941–73.

    Google Scholar 

  • Baicker, K., and D.P. Goldman. 2011. Patient cost sharing and health care spending growth. Journal of Economic Perspectives 25(2): 47–68.

    Article  Google Scholar 

  • Baicker, K., S.L. Taubman, H.L. Allen, et al. 2013. The Oregon Experiment – Effects of Medicaid on clinical outcomes. New England Journal of Medicine 368(18): 1713–22.

    Article  Google Scholar 

  • Chandra, A., J. Gruber, and R. McKnight. 2010. Patient cost-sharing and hospitalization offsets in the elderly. American Economic Review 100(1): 193–213.

    Article  Google Scholar 

  • Chandra, A., J. Gruber, and R. McKnight. 2014. The impact of patient cost sharing on the poor: Evidence from Massachusetts. Journal of Health Economics 33: 57–66.

    Article  Google Scholar 

  • Choudhry, N.K., J. Avorn, R.J. Glynn, et al. 2011. Full coverage for preventive medications after myocardial infarction. New England Journal of Medicine 365(22): 2088–97.

    Article  Google Scholar 

  • Choudhry, N.K., K. Bykov, W.H. Shrank, et al. 2014. Eliminating medication copayments reduces disparities in cardiovascular care. Health Affairs 33(5): 863–70.

    Article  Google Scholar 

  • Congressional Budget Office. 2006. Consumer-directed health plans: Potential effects on health care spending and outcomes. Washington, DC: Congressional Budget Office.

    Google Scholar 

  • Congressional Budget Office. 2010. Selected CBO publications related to health care legislation, 2009–2010. Washington, DC: Congressional Budget Office.

    Google Scholar 

  • Congressional Budget Office. 2013. Health-related options for reducing the deficit: 2014 to 2023. Washington, DC: Congressional Budget Office.

    Google Scholar 

  • Cookson, R., and K. Claxton (eds.). 2012. The humble economist: Tony Culyer on health, health care, and social decision making. York: York Publishing Services.

    Google Scholar 

  • Duan, N., W.G. Manning Jr., C.N. Morris, et al. 1983. A comparison of alternative models of the demand for medical care. Journal of Business and Economic Statistics 1(2): 115–25.

    Google Scholar 

  • Evans, R.G. 1984. Strained Mercy: The economics of Canadian health care. Toronto: Butterworths.

    Google Scholar 

  • Finkelstein, A., and S.L. Taubman. 2015. Randomize evaluations to improve health care delivery. Science 347(6223): 720–2.

    Article  Google Scholar 

  • Finkelstein, A., S. Taubman, B. Wright, et al. 2011. The Oregon Health Insurance Experiment: Evidence from the first year. Cambridge: National Bureau of Economic Research.

    Book  Google Scholar 

  • Institute of Medicine. 1999. To err is human. Washington, DC: National Academy Press.

    Google Scholar 

  • Institute of Medicine. 2001. Crossing the quality chasm: A new health system for the 21st century. Washington, DC: National Academy Press.

    Google Scholar 

  • Manning, W.G., J.P. Newhouse, N. Duan, et al. 1987. Health insurance and the demand for medical care: Results from a randomized experiment. American Economic Review 77(3): 251–77.

    Google Scholar 

  • Michalopoulos, C., D. Wittenburg, D.A.R. Israel, et al. 2011. The accelerated benefits demonstration and evaluation project: Impacts on health and employment at twelve months. New York: Manpower Demonstration Research Corporation.

    Google Scholar 

  • Newhouse, J.P., and The Insurance Experiment Group. 1993. Free for all? Lessons from the RAND Health Insurance Experiment. Cambridge: Harvard University Press.

    Google Scholar 

  • Newhouse, J.P., R.H. Brook, N. Duan, et al. 2008. Attrition in the RAND Health Insurance Experiment: A response to Nyman. Journal of Health Politics, Policy, and Law 33(2): 295–308.

    Article  Google Scholar 

  • Nyman, J.A. 2007. American health policy: Cracks in the foundation? Journal of Health Politics, Policy, and Law 32(5): 759–83.

    Article  Google Scholar 

  • Olken, B.A., J. Onishi, and S. Wong. 2011. Indonesia’s PNPM Generasi program: Final impact evaluation report. Washington, DC: The World Bank.

    Google Scholar 

  • Pauly, M.V. 1968. Comment. American Economic Review 58(3): 531–7.

    Google Scholar 

  • Powell-Jackson, T., K. Hanson, C.J.M. Whitty, et al. 2014. Who benefits from free healthcare? Evidence from a randomized experiment in Ghana. Journal of Development Economics 107: 305–19.

    Article  Google Scholar 

  • Rice, T.H. 1998. The economics of health reconsidered. Chicago: Health Administration Press.

    Google Scholar 

  • Robins, P.K. 1985. A comparison of the labor supply findings from the four negative income tax experiments. Journal of Human Resources 20(4): 567–82.

    Article  Google Scholar 

  • Rothschild, M., and J. Stiglitz. 1976. Equilibrium in competitive insurance markets: An essay on the economics of imperfect information. Quarterly Journal of Economics 90(4): 629–50.

    Article  Google Scholar 

  • Sine, J.J. 1994. Demand for episodes of care in the China Health Insurance Experiment. Santa Monica: Rand. Pardee RAND Graduate School.

    Google Scholar 

  • Taubman, S.L., H.L. Allen, B.J. Wright, et al. 2014. Medicaid increases emergency department use: Evidence from Oregon’s Health Insurance Experiment. Science 343(6168): 263–8.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Editor information

Copyright information

© 2018 Macmillan Publishers Ltd.

About this entry

Check for updates. Verify currency and authenticity via CrossMark

Cite this entry

Newhouse, J.P. (2018). Use of Experiments in Health Care. In: The New Palgrave Dictionary of Economics. Palgrave Macmillan, London. https://doi.org/10.1057/978-1-349-95189-5_3013

Download citation

Publish with us

Policies and ethics