HEALTH SERVICE USE AMONG THE PREVIOUSLY UNINSURED: IS SUBSIDIZED HEALTH INSURANCE ENOUGH?
HEALTH SERVICE USE AMONG THE PREVIOUSLY UNINSURED: IS SUBSIDIZED HEALTH INSURANCE ENOUGH?
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DOI：
10.1002/hec.1780
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发表时间：
2012-10-01
期刊：
影响因子：
2.1
通讯作者：
Polsky, Daniel
中科院分区：
文献类型：
--
作者：
Decker, Sandra L.;Doshi, Jalpa A.;Polsky, Daniel
尽管已有研究表明，在65岁时获得联邦医疗保险会增加未参保者的医疗服务使用率，但改变习惯的难度或以前未参保者与投保人相比的特征差异可能意味着，以前未参保者继续以不同于其他人的方式使用医疗保健系统。这项研究使用与两项不同调查相关联的联邦医疗保险索赔数据--全国健康访谈调查和健康与退休研究--来描述65岁之前的保险状况与65岁开始使用联邦医疗保险覆盖的服务之间的关系。尽管我们没有发现医疗保险支出或根据以前的保险状况在住院次数方面存在统计上的显著差异，但我们确实发现，65岁之前没有保险的个人继续使用与那些私人保险的人不同的医疗保健系统。具体地说，他们去看办公室医生的次数减少了16%，但去医院急诊科和门诊部的次数分别增加了18%和43%。未来的一个关键问题可能是，为什么以前没有保险的人似乎继续使用与以前有保险的人不同的医疗体系。在实施医疗保险范围扩大时，考虑这个问题可能很重要。版权所有(C)2011 John Wiley&Sons，Ltd.
Although it has been shown that gaining Medicare coverage at age 65?years increases health service use among the uninsured, difficulty in changing habits or differences in the characteristics of previously uninsured compared with insured individuals may mean that the previously uninsured continue to use the healthcare system differently from others. This study uses Medicare claims data linked to two different surveysthe National Health Interview Survey and the Health and Retirement Studyto describe the relationship between insurance status before age 65?years and the use of Medicare-covered services beginning at age 65?years. Although we do not find statistically significant differences in Medicare expenditures or in the number of hospitalizations by previous insurance status, we do find that individuals who were uninsured before age 65?years continue to use the healthcare system differently from those who were privately insured. Specifically, they have 16% fewer visits to office-based physicians but make 18% and 43% more visits to hospital emergency and outpatient departments, respectively. A key question for the future may be why the previously uninsured seem to continue to use the healthcare system differently from the previously insured. This question may be important to consider as health coverage expansions are implemented. Copyright (c) 2011 John Wiley & Sons, Ltd.