Health Insurance, Labor Supply, and Health

健康保险、劳动力供应和健康

• 批准号: 8038401
• 负责人: Cathy J Bradley
• 金额: $ 24.77万
• 依托单位: VIRGINIA COMMONWEALTH UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2007
• 资助国家: 美国
• 起止时间: 2007-05-01 至 2013-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8038401
• 关键词: Address; Adherence; Adoption; Adult; Affect; Age; American; American Cancer Society; Behavior; Behavioral; Breast; Cancer Burden; Cancer Patient; Convalescence; Data; Data Analyses; Data Set; Decision Making; Dependence; Diagnosis; Diagnostic Neoplasm Staging; Dimensions; Disease; Dose; Employee; Employment; Experimental Designs; Failure; Family; Family member; Foundations; Frequencies; Health; Health Care Costs; Health Insurance; Health Policy; Health Status; Healthcare; In Situ; Incentives; Individual; Insurance; Insurance Coverage; Interruption; Intuition; Investigation; Knowledge; Laws; Maintenance; Malignant Neoplasms; Marketing; Massachusetts; Mastectomy; Medical Records; National Health Insurance; Newly Diagnosed; Occupations; Operative Surgical Procedures; Outcome; Parents; Patient Care; Patients; Physicians; Policies; Publishing; Questionnaires; Radiation; Recording of previous events; Recovery; Regimen; Relative (related person); Reporting; Research; SF-36; Science; Scientific Advances and Accomplishments; Shock; Source; Spouses; Stage at Diagnosis; Statutes and Laws; Taste Perception; Time; Uninsured; United States; Woman; Work; World War II; abstracting; base; breast cancer diagnosis; breast lumpectomy; cancer recurrence; cancer therapy; caregiving; chemotherapy; cost; expectation; experience; improved; innovation; malignant breast neoplasm; meetings; mortality; response; satisfaction; treatment adherence

DESCRIPTION (provided by applicant): Our proposed research uses a quasi-experimental design to estimate how treatment adherence, health outcomes, and labor supply respond to whether or not an individual's insurance is provided by their own employer. Because many women obtain health insurance through their spouse's employment, while many others obtain it through their own employment, the labor supply response of women to illness-and how that response depends on the source of the health insurance-provides a natural context for addressing our research questions. Thus, we chose employed, married women newly diagnosed with breast cancer and their spouses as subjects for an investigation into the relationship between ECHI, health, and labor supply. Our aims are: 1) To compare treatment and treatment adherence between women with employment- contingent health insurance and women with health insurance through their spouse. Suggestive evidence from our prior study indicated that women with ECHI may forego treatment (e.g., doses of radiation, courses of chemotherapy) to avoid interruptions in their ability to meet work demands. To formally investigate this, we propose to abstract treatment and treatment adherence data from medical records. We will then examine the relationship between treatment and treatment adherence based on source of health insurance. Treatment and treatment adherence may be indicative of long-term health outcomes such as cancer recurrence and mortality. 2) To compare changes in health status between women with employment- contingent health insurance and women with health insurance through their spouse. One of the most important aspects of our research is how policies such as ECHI ultimately affect health status. We will examine health status by obtaining women's responses to questionnaires (specifically, the SF-36 and the Functional Assessment of Cancer Therapy-Breast (FACT-B)) at 2, 6, and 12 months following diagnosis. 3) To compare labor supply responses to cancer between women with employment-contingent health insurance and women with health insurance through their spouse. We propose to collect data with which to compare the effects of breast cancer on the labor supply of employed married women 2, 6, and 12 months following diagnosis, relative to their labor supply at the time immediately preceding their diagnosis. 4) To examine the labor supply responses of spouses following their partner's breast cancer diagnosis. Conceivably, ECHI creates similar labor supply incentives for employed, healthy spouses of women with breast cancer as it does for women with the disease. Spouses with ECHI may maintain high labor supply and hence forego care giving activities so that they can preserve their ECHI. To our knowledge, this integral way of addressing the incentives and pitfalls of ECHI has not been previously examined.

描述（由申请人提供）：我们提出的研究使用准实验设计来估计治疗依从性、健康结果和劳动力供应如何响应个人的保险是否由其自己的雇主提供。由于许多妇女通过配偶的工作获得健康保险，而其他许多妇女通过自己的工作获得健康保险，因此妇女对疾病的劳动力供给反应——以及这种反应如何取决于健康保险的来源——为解决我们的研究问题提供了自然的背景。因此，我们选择新诊断出乳腺癌的已婚就业女性及其配偶作为 ECHI、健康和劳动力供给之间关系的调查对象。我们的目标是： 1) 比较拥有就业健康保险的女性和通过配偶拥有健康保险的女性的治疗和治疗依从性。我们之前研究的提示性证据表明，患有 ECHI 的女性可能会放弃治疗（例如放疗剂量、化疗疗程），以避免干扰她们满足工作需求的能力。为了正式调查这一点，我们建议从医疗记录中提取治疗和治疗依从性数据。然后，我们将根据健康保险的来源检查治疗和治疗依从性之间的关系。治疗和治疗依从性可能表明长期健康结果，例如癌症复发和死亡率。 2) 比较参加就业健康保险的女性和通过配偶参加健康保险的女性的健康状况变化。我们研究最重要的方面之一是 ECHI 等政策最终如何影响健康状况。我们将通过获取女性在诊断后 2、6 和 12 个月对问卷（特别是 SF-36 和癌症治疗功能评估 - 乳房 (FACT-B)）的答复来检查健康状况。 3) 比较拥有就业健康保险的女性和通过配偶拥有健康保险的女性的劳动力供给对癌症的反应。我们建议收集数据，以比较乳腺癌对已婚就业女性在诊断后 2、6 和 12 个月的劳动力供应与诊断前的劳动力供应的影响。 4) 检查配偶在其伴侣被诊断出乳腺癌后的劳动力供给反应。可以想象，ECHI 为患有乳腺癌的女性的健康就业配偶提供了与乳腺癌女性相似的劳动力供应激励措施。患有 ECHI 的配偶可能会维持较高的劳动力供应，因此放弃护理活动，以便保留他们的 ECHI。据我们所知，这种解决 ECHI 激励措施和陷阱的整体方法以前从未被研究过。

项目成果

Job attributes, job satisfaction and the return to health after breast cancer diagnosis and treatment.

• DOI: 10.1002/pon.3385
• 发表时间: 2014-02
• 期刊: Psycho-oncology
• 影响因子: 3.6
• 作者: Barnes AJ;Robert N;Bradley CJ
• 通讯作者: Bradley CJ

Does employer-provided health insurance constrain labor supply adjustments to health shocks? New evidence on women diagnosed with breast cancer.

• DOI: 10.1016/j.jhealeco.2013.06.008
• 发表时间: 2013-09
• 期刊: JOURNAL OF HEALTH ECONOMICS
• 影响因子: 3.5
• 作者: Bradley, Cathy J.;Neumark, David;Barkowski, Scott
• 通讯作者: Barkowski, Scott