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部署差距距作为一个工具变量:替代形式,估计器和规格.

Donghoon Lee1,2, Anirban Basu3

  • 1The CHOICE Institute, School of Pharmacy, University of Washington, Seattle, Washington, USA.

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概括

卫生研究中的仪器变量 (IV) 方法可以产生不同的因果效应估计. 作为IV的差距 (DD) 显示了根据方法的不同结果,影响了医疗成本分析.

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科学领域:

  • 卫生经济学 卫生经济学
  • 计量经济学 计量经济学
  • 因果推理因果推理

背景情况:

  • 仪器变量 (IV) 方法对于健康研究中的因果推理至关重要.
  • 通过各种IV方法估计的特定类型的治疗效果往往被低估了.
  • 差距距 (DD) 是健康研究中常用的IV,但它的应用有所不同.

研究的目的:

  • 调查不同的仪器变量 (IV) 方法,特别是差距 (DD),如何影响健康经济学中治疗效应的估计.
  • 评估营利性 (FP) 与非营利性 (NFP) 医院选择对精神病医院住院费用的因果影响.
  • 为了澄清在各种计量经济模型中使用DD作为IV时的参数的识别.

主要方法:

  • 文献综述总结了差距距 (DD) 作为仪表变量的使用 (IV).
  • 理论推理和一个案例研究,比较二阶段最小平方 (2SLS) 与二进制与连续DD.
  • 用二进制和连续DD应用双阶段残留含量 (2SRI),并与局部IV方法进行比较.

主要成果:

  • 当使用二阶段最小平方 (2SLS) 与二进制与连续微分距离 (DD) 时,对治疗效应的估计有显著的差异.
  • 两阶段的残留含量 (2SRI) 方法产生了类似的治疗效果估计,包括二进制和连续DD,提供了足够的控制函数建模.
  • 2SRI估计与局部IV方法的平均治疗效果估计密切一致,表明了解选择异质性的潜力.

结论:

  • 工具变量 (IV) 方法的选择,特别是差距距 (DD) 的实施,极大地影响了健康研究中的因果关系估计.
  • 两个阶段的残留含量 (2SRI) 与两个阶段的最小平方 (2SLS) 相比,提供了更强大的差距距 (DD) 方法来估计治疗效应.
  • 了解治疗效果的异质性对于准确评估医院类型 (营利性与非营利性) 对医疗保健成本的影响至关重要.