Differences in price elasticities of demand for health insurance: a systematic review.
Many health insurance systems apply managed competition principles to control costs and quality of health care. Besides other factors, managed competition relies on a sufficient price-elastic demand. This paper presents a systematic review of empirical studies on price elasticity of demand for health insurance. The objective was to identify the differing international ranges of price elasticity and to find socio-economic as well as setting-oriented factors that influence price elasticity. Relevant literature for the topic was identified through a two-step identification process including a systematic search in appropriate databases and further searches within the references of the results. A total of 45 studies from countries such as the USA, Germany, the Netherlands, and Switzerland were found. Clear differences in price elasticity by countries were identified. While empirical studies showed a range between -0.2 and -1.0 for optional primary health insurance in the US, higher price elasticities between -0.6 and -4.2 for Germany and around -2 for Switzerland were calculated for mandatory primary health insurance. Dutch studies found price elasticities below -0.5. In consideration of all relevant studies, age and poorer health status were identified to decrease price elasticity. Other socio-economic factors had an unclear impact or too limited evidence. Premium level, range of premiums, homogeneity of benefits/coverage and degree of forced decision were found to have a major influence on price elasticity in their settings. Further influence was found from supplementary insurance and premium-dependent employer contribution.
Institute of Health Economics and Clinical Epidemiology, University Hospital of Cologne, Gleueler Straße 176-178, 50935, Cologne, Germany. jonas.pendzialek@gmail.com.
Jonas B
JB
Pendzialek
Institute of Health Economics and Clinical Epidemiology, University Hospital of Cologne, Gleueler Straße 176-178, 50935, Cologne, Germany.
Dusan
D
Simic
Institute of Health Economics and Clinical Epidemiology, University Hospital of Cologne, Gleueler Straße 176-178, 50935, Cologne, Germany.
Stephanie
S
Stock
D000367:Age Factors; D003365:Costs and Cost Analysis / Q000191:economics* / Q000706:statistics & numerical data*; D006304:Health Status; D006801:Humans; D007348:Insurance, Health / Q000191:economics*; D038622:Internationality; D017059:Models, Econometric; D012737:Sex Factors; D012959:Socioeconomic Factors
Health insurance; Managed competition; Price elasticity; Systematic review