Medicare and the health of women with breast cancer
Medicare and the health of women with breast cancer
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DOI：
10.3368/jhr.xl.4.948
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发表时间：
2005-09-01
影响因子：
5.2
通讯作者：
Decker, SL
中科院分区：
文献类型：
--
作者：
Decker, SL
本文利用大多数美国人在 65 岁时保险状况的变化，调查了健康保险对健康和医疗服务使用的影响；即美国医疗保险计划的资格。采用断点回归设计来识别 65 岁时年龄与获得护理和健康状况之间关系的不连续性，特别是对于 65 岁之前更有可能没有保险的群体，例如高中以下学历的人或黑人和西班牙裔。本文重点关注与乳腺癌相关的卫生服务的使用和健康结果，乳腺癌是女性死亡的常见原因，并且良好的早期检测服务被认为可以显着提高生存率。结果显示，包括乳房 X 光检查在内的医疗服务的使用在 65 岁时出现断续增加，特别是对于没有高中学历的女性以及黑人和西班牙裔女性。白人和西班牙裔女性在 65 岁时诊断出晚期乳腺癌的概率也略有下降。
This paper investigates the effect of health insurance on health and the use of health services by exploiting a change in insurance status that occurs for most Americans at age 65; that is, eligibility for the U.S. Medicare program. A regression discontinuity design is employed to identify discontinuities at age 65 in the relationship between age and access to care and health status, especially for groups more likely to be uninsured prior to age 65, such as those with less than a high school education or blacks and Hispanics. The paper focuses on the use of health services and health outcome related to breast cancer, a common cause of death among women, and one for which good access to early detection services is thought to significantly improve survival. Results show that the use of health services including mammography increases discontinuously at age 65, especially for women without a high school degree and for black and Hispanic women. A modest decrease in the probability of late-stage breast cancer diagnosis at age 65 is also found for white and Hispanic women.