Doctoral Dissertation Research in Political Science: The Politics of States' Medicaid Managed Care: 1981-1998

本博士论文研究调查的长期目标是更好地了解如何与由国家一级的政策制定者作出的方案设计的决定影响目标人群通过医疗补助使用国家支持的医疗保健。具体来说，研究有以下目标：首先，研究旨在确定哪些环境（健康，经济和社会）和政治因素塑造国家的决定，要求医疗补助计划豁免？第二，为什么各州在医疗补助计划中的管理式医疗计划的设计和复杂性上各不相同？最后，管理式医疗计划的变化是否影响医疗保健的提供？具体来说，获得护理的机会和国家的成本是否因设计而异？为了回答这些问题，将采用多种设计和统计程序。事件计数的方法，使用50个国家从1981年到1998年提供了一个解释的决定因素的概率增加，以获得豁免。为了解决方案的多样性，访问和成本的问题，一组联立方程模型将被采用。创建指数以作为自变量和因变量。卫生保健融资管理局的数据以及博士收集的其他数据。学生将被用于这项研究。

The long term objective of this Doctoral Dissertation Research Investigation is to better understand how decisions with regards to program design made by state level policy makers affect the target populations use of state supported health care through Medicaid. Specifically, the research has the following goals: First, the research seeks to determine what environmental (health, economic, and social) and political factors shape the decisions of states to request Medicaid program waivers? Second, why do states vary in their design and complexity of managed care programs in Medicaid? Finally, do variations in managed care programs affect the delivery of health care? Specifically, does the access to care and the cost to state vary by design? To answer these questions multiple designs and statistical procedures will be employed. An event count approach using the 50 states from 1981 through 1998 provides an explanation of the determinants of an increased probability to obtain a waiver. To address the issues of program diversity, access, and cost a set of simultaneous equation models will be employed. Indices are created to serve both as independent and dependent variables. Health Care Financing Administration data as well as additional data collected by the Ph.D. student will be used in this study.