Hybrideseminar – Responses to cost-sharing: Do socio-demographic characteristics matter

Patient cost-sharing in health insurance tends to reduce moral hazard, but it may do so at the expense of equity and solidarity. The related out-of-pocket expenditure may disproportionately burden certain subgroups, such as those who incur higher healthcare costs or have less financial flexibility tocover additional expenses. We anticipate that these subgroups will respond differently to cost-sharing measures. With the help of a structural microsimulation model, we estimate the expected response to changes in cost-sharing across gender, age and income groups, also considering the interactions amongthese characteristics. We estimate the parameters of our model using Dutch individual-level healthcare data for the years 2011 to 2019. We find an overall average elasticity of approximately −0.12, with considerable variation in elasticities across age groups and less variation across income quintiles or between genders.