Ambulance Utilization in New York City after the Implementation of the Affordable Care Act

28 Pages Posted: 12 Apr 2018

See all articles by Charles Courtemanche

Charles Courtemanche

University of North Carolina (UNC) at Greensboro - Department of Economics

Andrew Friedson

University of Colorado at Denver - Department of Economics

Daniel I. Rees

University of Colorado Denver; National Bureau of Economic Research (NBER)

Abstract

Expanding insurance coverage could, by insulating patients from having to pay full cost, encourage the utilization of arguably unnecessary medical services. It could also eliminate (or at least diminish) the need for emergency services through increasing access to preventive care. Using publicly available data from New York City for the period 2013-2016, we explore the effect of the Affordable Care Act (ACA) on the volume and composition of ambulance dispatches. Consistent with the argument that expanding insurance coverage encourages the utilization of unnecessary medical services, we find that, as compared to dispatches for more severe injuries, dispatches for minor injuries rose sharply after the implementation of the ACA. By contrast, dispatches for pre-labor pregnancy complications decreased as compared to dispatches for women in labor.

Keywords: Affordable Care Act, ambulance, emergency medical service, health insurance, moral hazard

JEL Classification: I11, I13, I18

Suggested Citation

Courtemanche, Charles and Friedson, Andrew and Rees, Daniel I., Ambulance Utilization in New York City after the Implementation of the Affordable Care Act. IZA Discussion Paper No. 11444, Available at SSRN: https://ssrn.com/abstract=3158150

Charles Courtemanche (Contact Author)

University of North Carolina (UNC) at Greensboro - Department of Economics ( email )

Greensboro, NC 27402-6165
United States

Andrew Friedson

University of Colorado at Denver - Department of Economics ( email )

Campus Box 181
P.O. Box 173364
Denver, CO 80217-3364
United States

Daniel I. Rees

University of Colorado Denver ( email )

Campus Box 181
P.O. Box 173364
Denver, CO 80218
United States

National Bureau of Economic Research (NBER)

1050 Massachusetts Avenue
Cambridge, MA 02138
United States

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