Life Cycle Effects of Health Insurance on Elderly Health

健康保险对老年人健康的生命周期影响

• 批准号: 7090845
• 负责人: Jalpa A. Doshi
• 金额: $ 41.4万
• 依托单位: UNIVERSITY OF PENNSYLVANIA
• 依托单位国家: 美国
• 财政年份: 2004
• 资助国家: 美国
• 起止时间: 2004-09-15 至 2008-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7090845
• 关键词: Medicare /Medicaid; age difference; aging; clinical research; health care model; health care policy; health care service utilization; health economics; human data; human old age (65+); medically underserved population; model design /development; outcomes research; statistics /biometry

DESCRIPTION (provided by applicant): Studies suggest Medicare insurance has improved health outcomes for the elderly. However, what is unknown is whether the Medicare program, which provides near universal coverage for Americans over 65, may be rescuing those who lacked insurance while near-elderly or may be providing too little coverage too late for this group. Given that 25% of the near-elderly will experience a period without insurance, sorting out this relationship between health insurance and health in old age, could lead to important policy interventions to improve the health of the elderly. The principal aim of this project is to study whether these improvements ire more likely to occur among the elderly who were uninsured prior to qualifying for Medicare at age 65 or whether they occur equally among all Medicare beneficiaries. This study will inform whether a policy to extend Medicare to the near-elderly who have difficulty obtaining health insurance would improve their health trajectories into old age. Given that the Medicare program is facing insolvency and may have to consider raising the eligibility age to coincide with the increase in the eligibility age for Social Security, this study will also inform a policy of more immediate concern: how would changes in the age of eligibility for Medicare change health and medical service use of the elderly? The data source will be the Health and Retirement Study (HRS), which is an ongoing panel survey of a nationally representative cohort of 12,562 individuals who were 51-61 years old when the study started in 1992. Responses will be linked with their Medicare claims. A broad range of measures of health outcomes and medical service use will be evaluated. Before and after 65 changes in health trajectories and medical service use patterns will be estimated for the entire sample and for insurance status subgroups. Differences in these changes between groups will also be estimated. We will use these estimates to simulate the effect of changes in the age of Medicare eligibility on health, medical service use and Medicare expenditure.

描述(由申请人提供)：研究表明，医疗保险改善了老年人的健康状况。然而，尚不清楚的是，为65岁以上的美国人提供近乎全民覆盖的联邦医疗保险计划，是在拯救那些在接近老年时缺乏保险的人，还是为这一群体提供的覆盖范围太晚了。鉴于25%的近老年人将经历一段没有保险的时期，理清医疗保险与老年健康之间的关系，可能会导致重要的政策干预，以改善老年人的健康。该项目的主要目的是研究这些改善是更有可能发生在65岁有资格享受联邦医疗保险之前没有保险的老年人中，还是在所有联邦医疗保险受益人中平等发生。这项研究将告知，将医疗保险扩大到难以获得医疗保险的近老年人的政策是否会改善他们进入老年的健康轨迹。鉴于医疗保险计划正面临破产，可能不得不考虑提高资格年龄，以与提高领取社会保障的资格年龄相一致，这项研究将 还告知更直接关注的政策：获得医疗保险资格年龄的变化将如何改变老年人的健康和医疗服务使用？数据来源将是健康和退休研究(HRS)，这是一项正在进行的小组调查，对象是全国有代表性的12562人，他们在1992年研究开始时年龄在51-61岁之间。回复将与他们的联邦医疗保险索赔挂钩。将对健康结果和医疗服务使用的广泛衡量标准进行评估。65年前和65年后，将估计整个样本和保险状况分组的健康轨迹和医疗服务使用模式的变化。还将估计不同组之间这些变化的差异。我们将使用这些估计来模拟医疗保险资格年龄变化对健康、医疗服务使用和医疗保险支出的影响。

项目成果

Would insuring near-elderly persons reduce Medicare spending in patients aged 65 years or older?

为接近老年人投保会减少 65 岁或以上患者的医疗保险支出吗？

• DOI: 10.7326/0003-4819-152-7-201004060-00021
• 发表时间: 2010
• 期刊: Annals of internal medicine
• 影响因子: 39.2
• 作者: Polsky,Daniel;Decker,SandraL
• 通讯作者: Decker,SandraL

Impact of a prescription copayment increase on lipid-lowering medication adherence in veterans.

• DOI: 10.1161/circulationaha.108.783944
• 发表时间: 2009-01-27
• 期刊: Circulation
• 影响因子: 37.8
• 作者: Doshi JA;Zhu J;Lee BY;Kimmel SE;Volpp KG
• 通讯作者: Volpp KG

HEALTH SERVICE USE AMONG THE PREVIOUSLY UNINSURED: IS SUBSIDIZED HEALTH INSURANCE ENOUGH?

• DOI: 10.1002/hec.1780
• 发表时间: 2012-10-01
• 期刊: HEALTH ECONOMICS
• 影响因子: 2.1
• 作者: Decker, Sandra L.;Doshi, Jalpa A.;Polsky, Daniel
• 通讯作者: Polsky, Daniel

Impact of the Medicare Modernization Act of 2003 on utilization and spending for medicare part B-covered biologics in rheumatoid arthritis.

2003 年《医疗保险现代化法案》对类风湿关节炎医疗保险 B 部分涵盖的生物制剂的利用和支出的影响。

• DOI: 10.1002/acr.20010
• 发表时间: 2010
• 期刊: Arthritis care & research
• 影响因子: 4.7
• 作者: Doshi,JalpaA;Li,Pengxiang;Puig,Andrea
• 通讯作者: Puig,Andrea