The link between public and private insurance and HIV-related mortality
The link between public and private insurance and HIV-related mortality
复制标题
DOI：
10.1016/j.jhealeco.2003.07.001
复制
发表时间：
2003-11-01
影响因子：
3.5
通讯作者：
Sood, N
中科院分区：
文献类型：
--
作者：
Bhattacharya, J;Goldman, D;Sood, N
在政策制定者考虑扩大对艾滋病毒阳性人群的保险覆盖面时，有必要询问保险是否对健康结果有任何影响，如果有影响，公共保险在预防过早死亡方面是否与私人保险一样有效。我们利用一个全国性的定期接受医疗护理的HIV感染者队列的数据，估计了不同类型的保险对这一人群死亡率的影响。我们的主要发现是：（1）忽略观察到的和未观察到的健康状况会误导人们得出保险可能对HIV患者没有保护作用的结论;（2）在考虑了观察到的和未观察到的异质性之后，保险确实能防止过早死亡，（3）私人保险比公共保险更有效。私人保险的更好表现可以部分解释为更严格的医疗补助处方药政策限制了获得高效治疗的机会。(C)2003 Elsevier B. V.保留所有权利。
As policymakers consider expanding insurance coverage for the human immunodeficiency virus (HIV+) population, it is useful to ask whether insurance has any effect on health outcomes, and, if so, whether public insurance is as efficacious as private insurance in preventing premature death. Using data from a nationally representative cohort of HIV-infected persons receiving regular medical care, we estimate the impact of different types of insurance on mortality in this population.Our main findings are that (1) ignoring observed and unobserved health status misleads one to conclude that insurance may not be protective for HIV patients, (2) after accounting for observed and unobserved heterogeneity, insurance does protect against premature death, and (3) private insurance is more effective than public insurance. The better performance of private insurance can be explained in part by more restrictive Medicaid prescription drug policies that limit access to highly efficacious treatment. (C) 2003 Elsevier B.V. All rights reserved.