title: The impact of financing of screening tests on utilization and outcomes: The case of amniocentesis.
abstract: We use a 1993 policy change in Israel's public healthcare system that lowered the eligibility age for amniocentesis to 35 to study the effects of financing of screening tests. Financing is found to have increased amniocentesis testing by about 35%. At ages above the eligibility threshold, utilization rates rose to roughly 33%, reflection nearly full takeup among prospective users of amniocentesis. Additionally, whereas below the age-35 threshold amniocentesis utilization rates increase with maternal age, this relation is muted above this age. Finally, no evidence is found that financing affects outcomes such as pregnancy terminations and births of children with Down syndrome. These results support the view that women above the eligibility threshold tend to refrain from acquiring inexpensive information about their degree of risk that absent the financing they would acquire, and instead, undergo the accurate and costly test regardless of additional information that noninvasive screening would provide.
authors.affiliation: Department of Economics, The Hebrew University, Jerusalem 91905, Israel. Electronic address: ity.shurtz@huji.ac.il.
authors.forename: Ity
authors.initials: I
authors.lastname: Shurtz
authors.affiliation: Patricia and Russell Fleischman Center for Women's Health, Hadassah Medical Center, Jerusalem, Israel. Electronic address: amnonbrz@gmail.com.
authors.forename: Amnon
authors.initials: A
authors.lastname: Brzezinski
authors.affiliation: Genetics Laboratory, Hadassah Medical Center, Jerusalem, Israel. Electronic address: Frumkin@hadassah.org.il.
authors.forename: Ayala
authors.initials: A
authors.lastname: Frumkin
mesh_terms: D000649:Amniocentesis / Q000191:economics* / Q000706:statistics & numerical data; D004314:Down Syndrome / Q000175:diagnosis; D005260:Female; D006291:Health Policy / Q000191:economics*; D006801:Humans; D007557:Israel; D008423:Maternal Age; D011247:Pregnancy; D011446:Prospective Studies; D012306:Risk
keywords: Behavior Health; Government Policy; Health Insurance; Public Health; Public and Private Health; Regulation