Designing an Optimal Financing Mechanism for Dental Care Among the Elderly: Reducing the Costs Associated with Information Assymmetries

在这个项目中，我们将记录与为65岁及以上的个人提供牙科护理的各种融资机制相关的成本和健康结果。此外，我们将分析现有融资机制和为这项研究开发的额外机制为老年人提供牙科护理的成本效益。评估筹资机制的关键是了解信息不对称的作用，信息不对称会推高保险费，导致购买的保险数量和牙科服务的利用低于社会最佳水平。该项目的基本框架是一个最优化模式，该模式最大限度地减少牙科服务的总成本，条件是一级预防和二级预防的收入额等于其最高可行价值。我们将使用这个优化模型来比较现有的牙科保健筹资机制以及在这项研究中设计的混合和新机制。由于持续上涨的成本以及穷人和富人在健康状况和预防保健接受方面的差异，许多人认为美国的卫生服务提供处于危机时刻。老年人健康服务的一个经常被忽视的领域是牙科护理，其通货膨胀率最近超过了医疗保健通货膨胀率。每年用于牙科保健的费用约为610亿美元。在这项研究中，我们将评估缺乏牙科保险对疾病的影响，确定各种形式的卫生分配的有效性，制定改进这种分配的策略，并设计一个框架来分析可能推广到其他卫生保健领域的成本。例如，随着老年人产生的医疗费用增加，扩大医疗保险覆盖范围的压力将会增加，例如处方药。然而，老年人有一些独特的特点，可能会使分配变得困难。低收入人群也存在许多类似的问题。

In this project, we will document costs and health outcomes associated with various financing mechanisms for delivering dental care to individuals age 65 and above. In addition we will analyze the cost-effectiveness of existing financing mechanisms and additional mechanisms developed for this research to deliver dental care to the elderly. Key to evaluation of financing mechanisms is an understanding of the roles of information asymmetries, which can drive up insurance premiums and result in the less than the socially optimal quantity of insurance purchased and utilization of dental services. The basic framework of the project is an optimization model that minimizes the total cost of dental services subject to receipt of primary and secondary prevention equaling its highest feasible value. We will use this optimization model to compare existing financing mechanisms for dental care as well as hybrid and new mechanisms designed in this research.The delivery of health services in the United States is considered by many to be at a crisis point due to both the continued rising costs and disparities in the health status and receipt of preventive care between the poor and wealthy. One area of health service for the elderly that is often ignored is dental care where the rate of inflation has recently outpaced the medical care inflation rate. Approximately $61 billion is spent annually on dental care. In this research we will estimate the impact that the lack of dental insurance has on disease, determine how effective various forms of health allocation are, develop strategies to improve this allocation, and design a framework to analyze costs which may be generalized to other areas of health care. For example, as health care costs incurred by the elderly increase, there will be increasing pressure to extend Medicare coverage, e.g. prescription drugs. However, there are unique characteristics to the elderly that may make allocation difficult. Many similar issues exist for the low-income population.