Public health insurance and medical treatment: the equalizing impact of the Medicaid expansions
Public health insurance and medical treatment: the equalizing impact of the Medicaid expansions
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DOI：
10.1016/s0047-2727(00)00140-7
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发表时间：
2001-10-01
影响因子：
9.8
通讯作者：
Gruber, J
中科院分区：
文献类型：
--
作者：
Currie, J;Gruber, J
我们调查的影响，扩大公共医疗保险的妇女在分娩时接受的医疗，使用生命统计数据在美国的每一个出生在1987-1992年期间。在此期间，医疗补助计划下的公共保险覆盖资格的巨大变化确定了保险状态对治疗的影响。在教育程度低的母亲中，在获得医疗补助资格之前基本上没有保险，获得该计划的资格与各种产科手术的使用显着增加有关。然而，在受教育程度较高的妇女中，对使用程序有抵消作用。这些妇女中的大多数在获得医疗补助资格之前都有私人保险，有些人可能已经被“挤出”到公共计划中，从更慷慨地报销医疗保健的保险转移到报销少得多的保险。这一变化伴随着手术使用的减少。因此，从净上看，医疗补助的扩大具有均衡效应，增加了以前未投保者的治疗强度，同时降低了以前投保者的治疗强度。(C)2001爱思唯尔科技有限公司。保留所有权利。
We investigate the impact of expanding public health insurance on the medical treatment received by women at childbirth, using Vital Statistics data on every birth in the US over the 1987-1992 period. The effects of insurance status on treatment are identified using the tremendous variation in eligibility for public insurance coverage under the Medicaid program over this period. Among low education mothers who were largely uninsured before being made eligible for Medicaid, eligibility for this program was associated with significant increases in the use of a variety of obstetric procedures. Among women with more education, however, there is a countervailing effect on procedure use. Most of these women had private insurance before becoming Medicaid-eligible, and some may have been 'crowded out' onto the public program, moving from insurance which reimburses medical care more generously to insurance with much less generous reimbursement. This movement was accompanied by reductions in procedure use. Thus, on net, the Medicaid expansions had an equalizing effect, increasing the treatment intensity of the previously uninsured while lowering it among the previously insured. (C) 2001 Elsevier Science B.V. All rights reserved.