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Dental Coverage Transistions, Utilization and Retirement

牙科保险的过渡、利用和退休

基本信息

批准号：
8295952
负责人：
RICHARD J MANSKI
金额：
$ 36.15万
依托单位：
UNIVERSITY OF MARYLAND BALTIMORE
依托单位国家：
美国
项目类别：
财政年份：
2005
资助国家：
美国
起止时间：
2005-07-01 至 2014-06-30
项目状态：
已结题

项目摘要

DESCRIPTION (provided by applicant): The goal of this project is to provide a better understanding of the relationship between dental care coverage and dental use among the elderly and subsequently provide the information needed to assist policy makers as they consider the inclusion of dental coverage under Medicare, Medigap and Medicaid plans or as an extension of post-retirement coverage within the private sector. This project is a collaborative effort of a multidisciplinary research team and will be conducted using data available from the Institute for Social Research (ISR) at the University of Michigan and The RAND Corporation. Specifically this project will: 1. Estimate the number and characteristics of those persons age 51 years and above who stay covered by dental insurance after retirement, stay uninsured after retirement, lose coverage after retirement, or gain coverage after retirement. The working hypothesis for this specific aim is that persons are less likely to have dental care coverage after retirement. 2. Estimate dental care use as a function of dental care coverage status and transitions controlling for individual and household characteristics and adverse selection. The working hypothesis for this specific aim is that persons are less likely to have a dental visit without dental care coverage. 3a. Estimate dental care out-of pocket expenditures as a function of dental care coverage and retirement status and transitions controlling for individual and household characteristics and adverse selection. The working hypothesis for this specific aim is that persons with a dental visit who are retired and/or without dental coverage will have higher out-of-pocket expenditures. 3b. Estimate changes in dental care out-of-pocket expenditures as a function of dental care coverage and retirement transitions controlling for individual and household characteristics and adverse selection. The working hypothesis for this specific aim is that persons with a dental visit who become retired and/or without dental coverage will have higher out-of-pocket expenditures. 4. Estimate the relationships between dental care use, coverage, and out-of-pocket payments and net wealth status and transitions, controlling for individual and household characteristics and adverse selection. The working hypothesis is that lower levels of, and reductions in, net wealth are associated with less dental care utilization and coverage, and higher out-of-pocket payments for those using dental care. 5. Estimate dental care use by dental procedure type as a function of oral health and dental care coverage status controlling for individual and household characteristics and adverse selection. The working hypothesis for this specific aim is that dental coverage induces regular preventive dental care, improves oral health, and lessens the need for expensive non-preventive procedures. 6. Estimate the number and characteristics of persons age 51 years and above reporting dental care coverage with atypically low levels of dental use and/or atypically high levels of out of pocket expenditures for those with dental use. The working hypothesis for this specific aim is that these groups are more likely to expect that dental coverage is included in Medicare and as a consequence mis-report having dental coverage. Results of this project will assist policy makers in the formulation of governmental policies, including a proposed extension of Medicare to include dental coverage, inclusion of dental coverage under Medigap plans, inclusion of full adult dental care coverage in Medicaid and an extension of post-retirement continuation coverage to include dental coverage within the private sector. PUBLIC HEALTH RELEVANCE: The goal of this project is to provide a better understanding of the relationship between dental care coverage and dental use among the elderly and subsequently provide the information needed to assist policy makers as they consider the inclusion of dental coverage under Medicare, Medigap and Medicaid plans or as an extension of post-retirement coverage within the private sector.

描述（由申请人提供）：该项目的目标是更好地了解老年人的牙科护理保险和牙科使用之间的关系，并随后提供所需的信息，以协助政策制定者考虑将牙科保险纳入 Medicare、Medigap 和 Medicaid 计划，或作为私营部门退休后保险的延伸。该项目是多学科研究团队的合作成果，将使用密歇根大学社会研究所 (ISR) 和兰德公司提供的数据进行。具体而言，该项目将： 1. 估算 51 岁及以上退休后继续享受牙科保险、退休后未参加保险、退休后失去保险或退休后获得保险的人数和特征。这一具体目标的工作假设是，人们退休后不太可能获得牙科护理保险。 2. 根据牙科护理覆盖状况和控制个人和家庭特征以及逆向选择的转变来估计牙科护理使用情况。这一具体目标的工作假设是，如果没有牙科护理保险，人们就不太可能去看牙医。 3a.根据牙科护理覆盖范围和退休状况以及控制个人和家庭特征和逆向选择的过渡来估计牙科护理自付费用。这一具体目标的工作假设是，去看牙医的退休人员和/或没有牙科保险的人将有更高的自付费用。 3b.估计牙科护理自付费用随牙科护理覆盖范围和退休过渡的变化，并控制个人和家庭特征以及逆向选择。这一具体目标的工作假设是，退休后去看牙医和/或没有牙科保险的人将有更高的自付费用。 4. 估计牙科护理使用、覆盖范围和自付费用与净财富状况和转变之间的关系，控制个人和家庭特征以及逆向选择。有效的假设是，净财富水平的降低和净财富的减少与牙科护理利用率和覆盖范围的减少以及使用牙科护理的人的自付费用较高有关。 5. 根据口腔健康和牙科护理覆盖状况，根据牙科手术类型估计牙科护理使用情况，并控制个人和家庭特征以及逆向选择。这一具体目标的工作假设是，牙科保险可以促进定期的预防性牙科护理，改善口腔健康，并减少对昂贵的非预防性手术的需求。 6. 估计 51 岁及以上报告牙科护理覆盖率异常低水平的牙科使用和/或异常高水平的牙科使用自付费用的人的数量和特征。这一具体目标的工作假设是，这些群体更有可能期望牙科保险包含在医疗保险中，因此误报有牙科保险。该项目的结果将协助政策制定者制定政府政策，包括拟议扩大医疗保险范围以纳入牙科保险、将牙科保险纳入 Medigap 计划、将成人牙科护理全面纳入医疗补助以及扩大退休后延续保险范围以纳入私营部门的牙科保险。公共健康相关性：该项目的目标是更好地了解老年人的牙科护理覆盖范围和牙科使用之间的关系，并随后提供所需的信息，以协助政策制定者考虑将牙科覆盖范围纳入医疗保险、医疗补助计划和医疗补助计划，或作为私营部门退休后覆盖范围的延伸。