The Causal Effect of Health Insurance on Utilization and Outcomes in Adults

Freeman, Joseph D.; Kadiyala, Srikanth; Bell, Janice F.; Martin, Diane P.

doi:10.1097/mlr.0b013e318185c913

Cited by 220 publications

(187 citation statements)

References 28 publications

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“…The uninsured tend to receive less medical care and thus be in worse health than the insured (Finkelstein et al 2011, Card et al, 2009Doyle, 2005; also see the reviews in McWilliams, 2009 andFreeman et al, 2008). Moreover, uninsured individuals are at risk of severe financial loss, including bankruptcy, in the event of illness (Gross and Notowidigdo, 2011;Himmelstein et al, 2009).…”

Section: Introductionmentioning

confidence: 99%

The Impact of the Macroeconomy on Health Insurance Coverage: Evidence from the Great Recession

Cawley¹,

Moriya²,

Simon³

2011

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Standard-Nutzungsbedingungen:Die Dokumente auf EconStor dürfen zu eigenen wissenschaftlichen Zwecken und zum Privatgebrauch gespeichert und kopiert werden.Sie dürfen die Dokumente nicht für öffentliche oder kommerzielle Zwecke vervielfältigen, öffentlich ausstellen, öffentlich zugänglich machen, vertreiben oder anderweitig nutzen.Sofern die Verfasser die Dokumente unter Open-Content-Lizenzen (insbesondere CC-Lizenzen) zur Verfügung gestellt haben sollten, gelten abweichend von diesen Nutzungsbedingungen die in der dort genannten Lizenz gewährten Nutzungsrechte. www.econstor.eu The Institute for the Study of Labor (IZA) in Bonn is a local and virtual international research center and a place of communication between science, politics and business. IZA is an independent nonprofit organization supported by Deutsche Post Foundation. The center is associated with the University of Bonn and offers a stimulating research environment through its international network, workshops and conferences, data service, project support, research visits and doctoral program. IZA engages in (i) original and internationally competitive research in all fields of labor economics, (ii) development of policy concepts, and (iii) dissemination of research results and concepts to the interested public. Terms of use: Documents in D I S C U S S I O N P A P E R S E R I E SIZA Discussion Papers often represent preliminary work and are circulated to encourage discussion. Citation of such a paper should account for its provisional character. A revised version may be available directly from the author. . We find that a one percentage point increase in the state unemployment rate is associated with a 1.67 percentage point (2.12%) reduction in the probability that men have health insurance; this effect is strongest among college-educated, white, and older (50-64 year old) men. We estimate that 9.3 million Americans, the vast majority of whom were adult men, lost health insurance due to a higher unemployment rate alone during the 2007-09 recession. We conclude with a discussion of how components of recent health care reform may influence this relationship in the future.JEL Classification: I10, J3, J6, E32

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Section: Introductionmentioning

confidence: 99%

The Impact of the Macroeconomy on Health Insurance Coverage: Evidence from the Great Recession

Cawley¹,

Moriya²,

Simon³

2011

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“…16 By improving access to care, health insurance coverage is fundamentally important to better health care and health outcomes. 17 The ACA requires that insurance plans issued on or after September 23, 2010 (or August 1, 2012, for certain services) cover a wide range of preventive services at no cost to the enrollee: 15 covered services for all adults, an additional 22 for women, and an additional 26 for children.…”

Section: Discussionmentioning

confidence: 99%

Insurance Coverage and Preventive Care Among Adults

Lines¹,

Urato²,

Halpern³

et al. 2014

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This PDF document was made available from www.rti.org as a public service of RTI International. More information about RTI Press can be found at http://www.rti.org/rtipress. RTI International is an independent, nonprofit research organization dedicated to improving the human condition by turning knowledge into practice. The RTI Press mission is to disseminate information about RTI research, analytic tools, and technical expertise to a national and international audience. RTI Press publications are peer-reviewed by at least two independent substantive experts and one or more Press editors. All rights reserved. This report is protected by copyright. Credit must be provided to the author and source of the document when the content is quoted. Neither the document nor partial or entire reproductions may be sold without prior written permission from the publisher. www.rti.org/rtipress AbstractThe Affordable Care Act (ACA) is intended to provide health insurance to all US citizens, but many people will likely continue to have gaps in their insurance coverage after reform. For this study, we used longitudinal survey data from Panel 11 (2006)(2007) of the Medical Expenditure Panel Survey to examine the effect of gaps in insurance coverage on adults' receipt of preventive screening. We categorized individuals (n = 8,985) between the ages of 18 and 64 at baseline as continuously insured (private only or any public), intermittently insured, or continuously uninsured. Outcome measures were routine checkup, blood pressure check, cholesterol check, flu shot, sigmoidoscopy or colonoscopy, mammogram, Pap smear, and an overall composite measure. Logistic regression models controlled for age, sex, race, limited English proficiency, education, urbanicity, census region, income, perceived health, and employment status. Crude rates of receiving preventive services were generally highest for those with public insurance and lowest for the continuously uninsured. In adjusted analyses, having intermittent coverage increased the odds of receiving no preventive services to 1.64 compared with continuous private insurance. Continuously lacking insurance increased the odds of receiving no preventive services to 4.41 compared with continuous private coverage. The effect of intermittent coverage was larger than the effect of race/ethnicity, education, where individuals lived, perceived health status, or employment status. Lack of continuous health insurance is a critical barrier to receiving appropriate health care services. Implementation of the ACA will be less successful if gaps in coverage are not prevented.

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“…11,12,19,[21][22][23][24][25][26][27][28] Sağ lık si gor ta sı nın ta nı ve te da vi edi ci, ko ru yu cu sağ lık hiz me ti ni ve kul la nı -mı nı art tı ra rak sağ lı ğı olum lu et ki le di ği, ki şi nin ken di si ni da ha sağ lık lı his set me si ni sağ la dı ğı, hasta lan ma ve ya ra lan ma ya bağ lı ölüm oran la rı nı dü-şür dü ğü tes pit edil miş ve sağ lık si gor ta sı nın, sağ lık ve sağ lık hiz me ti kul la nı mı ara sın da ki iliş ki yi et kile yen al tın bir stan dart ol du ğu ifa de edil miş tir. 29 Bu ça lış ma da ayak ta ta nı ve te da vi hiz met le ri kul la nı mın da sos yal sı nıf lar ara sın da fark bu lunma sı nın ve ya ta rak ta nı ve te da vi de ise fark bu lunma ma sı nın önem li bir ne de ni has ta ne ye ya tış ge rek ti ren sağ lık so run la rı nın da ha cid di ve er te lene mez ol ma özel li ği ola bi lir. Has ta ne de ya ta rak tanı ve te da vi kul la nı mı açı sın dan, sos yo e ko no mik far kın ol ma dı ğı bil di ril mek te dir.…”

Section: Tar Tiş Maunclassified

Effect of Social Class and Social Security on Access to Healthcare in Manisa: A Research for Inequalities

Nesanir¹,

Dinç²,

Cambaz³

et al. 2010

Turkiye Klinikleri J Med Sci

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Ö ÖZ ZE ET T A Am ma aç ç: : Bu çalışmada sosyal sınıf ve sağlık güvencesinin Manisa'daki ayakta ve yatarak tanı ve tedavi hizmeti kullanımı üzerine etkisi değerlendirilmiştir. G Ge er re eç ç v ve e Y Yö ön nt te em ml le er r: : Manisa kent merkezi nüfusunu (n=232.760) temsil eden 11.284 hane halkı bireyine sağlık evi nüfuslarına orantılı küme örnek seçimi yöntemi ile ulaşılmıştır. Veriler, anket yapılan kişilere anketörler tarafın-dan yüz yüze görüşme tekniği uygulanarak toplanmıştır. Farklı sosyal sınıfların ve sağlık güvencesi varlığının sağlık sorunu yaşama, ayakta ve yatarak tanı ve tedavi hizmetlerine ulaşma açısından kaba riskleri hesaplanmıştır. Çok değişkenli riskler yaş, cinsiyet ve kronik hastalık varlığına göre dü-zeltilmiştir. B Bu ul lg gu ul la ar r: : İşsizlerle karşılaştırıldığında son on beş günde üst sosyal sınıfta 1.79 (1.17-2.75), orta sosyal sınıfta 1.51 (1.10-2.06) ve alt sosyal sınıfta 1.44 (1.04-2.00) kat daha fazla sağlık sorunu yaşandığı tespit edilmiştir. Yine işsizlerle karşılaştırıldığında son on beş günde üst sosyal sı-nıfta 1.73 (1.08-1.46), orta sosyal sınıfta 1.46 (1.03-2.06), alt sosyal sınıfta 1.53 (1.07-2.20) kat daha fazla ayakta tanı ve tedavi hizmeti kullanımı olduğu anlaşılmıştır. Farklı sosyal sınıfların yaş, cinsiyet ve kronik hastalığa göre düzeltilmiş yatarak tanı ve tedavi görme riskleri benzerdir. Bununla birlikte sağlık güvencesi olanlarda, olmayanlara göre son on beş günde sağlık sorunu yaşadığını belirtme oranının 1.58 (1.17-2.13); son on beş günde ayakta tanı ve tedavi hizmeti alma oranının 2.57 (1.75-3.78) ve son bir yılda yatarak tanı ve tedavi görme oranının 3.37 (2.11-5.40) kat daha fazla olduğu ortaya çıkmıştır. S So on nu uç ç: : Sağlık hizmetine ulaşmada işsizler ve sağlık güvencesi bulunmayanlar aleyhine eşitsizlikler olduğu görülmektedir.A An na ah h t ta ar r K Ke e l li i m me e l le er r: : Sosyal sınıf; sosyal güvenlik; sağlık hizmetleri A AB BS S T TR RA AC CT T O Ob bj je ec ct ti iv ve e: : In the following study, effect of social class and social security on reaching diagnostic and therapeutic health care services in Manisa is evaluated in both out-patient and in-patient basis. M Ma at te er ri ia al l a an nd d M Me et th ho od ds s: : The households were determined in proportion to targeting populations in health care facilities (health houses) by using cluster sampling method and 11284 people representing the population in Manisa city center (n:232760) was included in the study. The data was collected by pollsters using face to face technique. Crude risks were calculated in different social classes and in those with or without social security for history of health problems and access to diagnostic and therapeutic health care services on outpatient and the inpatient basis. Multivariable risks were revised in accordance with age, sex and chronic health problems. R Re es su ul lt ts s: : In comparison to unemployed population, the health problems in last 15 days was 1.79 (1.17-2.75) times more common in upper social class and similar figures w...

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The Causal Effect of Health Insurance on Utilization and Outcomes in Adults

Cited by 220 publications

References 28 publications

The Impact of the Macroeconomy on Health Insurance Coverage: Evidence from the Great Recession

The Impact of the Macroeconomy on Health Insurance Coverage: Evidence from the Great Recession

Insurance Coverage and Preventive Care Among Adults

Effect of Social Class and Social Security on Access to Healthcare in Manisa: A Research for Inequalities

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