7 - How Health Insurance Affects Health

7 - 健康保险如何影响健康

• 批准号: 10224054
• 负责人: Katherine Baicker
• 金额: $ 15.22万
• 依托单位: NATIONAL BUREAU OF ECONOMIC RESEARCH
• 依托单位国家: 美国
• 财政年份: 1997
• 资助国家: 美国
• 起止时间: 1997-02-01 至 2023-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10224054
• 关键词: Accident and Emergency department; Address; Adult; Affect; Age; Asthma; Blood Glucose; Blood Pressure; Caring; Cholesterol; Chronic; Chronic Care; Chronic Disease; Collection; Data; Data Set; Data Sources; Dental; Dental Care; Detection; Diabetes Mellitus; Disease Management; Drug Prescriptions; Elderly; Emergency Situation; Enrollment; Environment; Evaluation; Financial Hardship; Health; Health Benefit; Health Insurance; Health behavior; Healthcare; Healthcare Systems; Hospital Departments; Hospitals; Insurance; Insurance Coverage; Low income; Machine Learning; Measures; Medicaid; Medical; Medicare; Mental Depression; Mental Health; Methods; Names; Oral health; Oregon; Outcome; Pattern; Patterns of Care; Personal Satisfaction; Physicians; Policies; Policy Maker; Prevalence; Preventive dental care; Primary Health Care; Public Health; Randomized; Research; Research Personnel; Resources; Risk; Site; Social Policies; Stream; Techniques; Testing; Time; Uninsured; Uninsured Medical Expense; Waiting Lists; Work; aged; aging population; care outcomes; diabetic; econometrics; experimental study; health management; improved; improved outcome; insight; multiple data sources; novel; physical conditioning; programs; public health insurance; public health relevance; randomized controlled design; synergism

PROJECT SUMMARY/ABSTRACT Project 7 – How Health Insurance Affects Health Understanding the consequences of health insurance coverage is central to evaluating proposals to expand or modify health insurance coverage in the U.S. Yet there is remarkably little convincing evidence on the impact of insuring the uninsured on their medical utilization, health outcomes, health behaviors, or overall well-being, largely because enrolling in health insurance is a choice that is made jointly with other choices that determine these outcomes. This project takes advantage of a remarkable opportunity to provide just such evidence. For a limited window in early 2008, Oregon opened a waiting list for enrollment in its public health insurance program for low income adults, and then randomly drew names from the list to determine who would be given the opportunity to enroll. This unique policy environment provided researchers with a rare occasion to bring the strengths of random assignment – the standard in medical trials – to address a critical social policy question. This proposal builds on our prior work assessing the effects of Medicaid on health care use, health, and well-being, including a focus on the near-elderly (those aged 50-64) whose health risks are in many ways similar to those aged 65 and up and who will soon age onto Medicare themselves. We found that Medicaid substantially increased health care use across settings (including primary care, hospitals, prescription drugs, and emergency departments (EDs)); reduced financial strain (including bills sent to collection and catastrophic out-of-pocket expenses); and reduced the prevalence of depression; but had no detectable effects on several measures of physical health (including blood pressure, cholesterol, and diabetic blood sugar control). This project will leverage our work on the Oregon Health Insurance Experiment to build several new data sets and conduct new analyses to assess multi-faceted effects of Medicaid coverage on health and other outcomes, including: care and health outcomes for chronic physical conditions and mental health, including diabetes, asthma, and depression; patterns of ED and hospital use over time and substitutability of different sites of care; and dental care and outcomes. We will also develop a novel econometric method for assessing and synthesizing the multidimensional effects of insurance on health. As policy-makers and stakeholders assess the broad consequences of expanded access to health insurance, we believe these analyses will add crucial evidence on the many potential effects of Medicaid on health care use, quality, and long-term health outcomes of an aging population.

项目总结/摘要 项目7 -健康保险如何影响健康 了解健康保险覆盖范围的后果是评估扩大或 修改美国的医疗保险覆盖范围，但几乎没有令人信服的证据表明其影响 为未投保者的医疗利用、健康结果、健康行为或整体福祉提供保险， 很大程度上是因为参加医疗保险是一个与其他决定性选择共同做出的选择， 这些结果。 这个项目利用了一个非凡的机会来提供这样的证据。在有限的时间内 2008年初，俄勒冈州为低收入者开放了一个公共健康保险计划的登记等候名单 然后从名单中随机抽取名字，以确定谁将有机会注册。 这种独特的政策环境为研究人员提供了一个难得的机会，使随机的优势， 这是医学试验的标准，目的是解决一个关键的社会政策问题。这一建议建立 我们先前的工作评估医疗补助对医疗保健使用，健康和福祉的影响，包括 重点关注近老年人（50-64岁），他们的健康风险在许多方面与65岁的人相似 而他们，也将在不久的将来，以自己的方式，我们发现医疗补助大幅增加 跨环境使用卫生保健（包括初级保健、医院、处方药和急诊 部门（ED））;减少财务压力（包括账单发送收集和灾难性的自付 费用）;并降低抑郁症的患病率;但对几项指标没有可检测的影响。 身体健康（包括血压、胆固醇和糖尿病血糖控制）。 这个项目将利用我们在俄勒冈州健康保险实验中的工作来建立几个新的数据集 并进行新的分析，以评估医疗补助覆盖范围对健康和其他结果的多方面影响， 包括：慢性身体疾病和精神健康，包括糖尿病的护理和健康结果， 哮喘和抑郁症;随着时间的推移，艾德和医院使用的模式以及不同护理地点的可替代性; 以及牙科护理和结果。我们还将开发一种新的计量经济学方法， 综合保险对健康的多方面影响。政策制定者和利益相关者评估 扩大医疗保险的广泛影响，我们相信这些分析将增加至关重要的 关于医疗补助对医疗保健使用、质量和长期健康结果的许多潜在影响的证据 人口老龄化的影响。