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What Does Health Insurance Do? Evidence from the Oregon Health Insurance Lottery

健康保险有什么作用？

基本信息

批准号：
7889243
负责人：
Katherine Baicker
金额：
$ 5.43万
依托单位：
NATIONAL BUREAU OF ECONOMIC RESEARCH
依托单位国家：
美国
项目类别：
财政年份：
2010
资助国家：
美国
起止时间：
2010-06-01 至 2015-05-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/7889243
关键词：
Accident and Emergency department Accounting Address Adult Affect Age Area Asses Behavior Caring Cholesterol Chronic Disease Collection Communities Costs and Benefits Data Data Collection Data Sources Developed Countries Diabetes Mellitus Drug Prescriptions Eating Economics Education Elderly Emergency Care Enrollment Environment Evaluation Funding Gold Health Health Expenditures Health Insurance Health Policy Health behavior outcomes Healthcare Hospitals Income Individual Influentials Insurance Insurance Coverage Interview Investments Lead Life Link Low income Mails Marketing Measurement Measures Medical Medicare Mental Health Names Obesity Oregon Outcome Outcomes Research Patient Self-Report Pattern Personal Satisfaction Persons Physiological Play Policies Population Preventive Primary Health Care Provider Public Health Race Randomized Records Reporting Research Research Personnel Risk Risk Behaviors Role Running Sampling Science Security Services Smoking Social Policies Surveys System Testing Uninsured United States Waiting Lists aged aging population blood pressure regulation comparison group control trial cost design drinking falls health care service utilization health economics improved interest mortality programs public health relevance research study satisfaction

项目摘要

DESCRIPTION (provided by applicant): 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. A remarkable opportunity has presented itself for providing just such evidence. For a limited window in early 2008, Oregon opened a waiting list for enrollment in its previously closed public health insurance program for certain 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 provides researchers with a rare occasion to bring the strengths of random assignment - the standard in medical trials - to address a critical social policy question. We have already begun surveying those selected and not selected in the lottery, and propose to use NIA funding to greatly extend the reach of our data collection and analysis, including over- sampling of 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 propose to capitalize on this extraordinary and unique opportunity to address questions in three different areas: First, how does insurance affect health care utilization? Second, what is the effect of insurance on health? Third, how do the effects of health insurance differ for different groups? We will answer these questions by drawing on three data sources: semi-annual mail surveys, an in-person data collection effort including measurement of physiological markers of health, and administrative records on hospital and emergency department use. PUBLIC HEALTH RELEVANCE: Understanding the consequences of health insurance coverage is central to evaluating proposals to expand or modify health insurance coverage in the U.S. The proposed research will take advantage of a unique policy experiment underway in Oregon to evaluate the causal effects of health insurance on health care utilization and health outcomes.

描述（申请人提供）：了解健康保险覆盖范围的后果是评估扩大或修改美国健康保险覆盖范围的建议的核心，然而，关于为未投保者投保对他们的医疗利用，健康结果，健康行为或整体福祉的影响，这主要是因为参加医疗保险是一个与其他决定这些结果的选择共同做出的选择。提供这种证据的绝佳机会已经出现。在2008年初的一个有限的窗口，俄勒冈州为某些低收入成年人开放了一个先前关闭的公共医疗保险计划的等候名单，然后从名单中随机抽取名字，以确定谁将有机会参加。这种独特的政策环境为研究人员提供了一个难得的机会，使随机分配的优势-在医学试验中的标准-来解决一个关键的社会政策问题。我们已经开始调查那些在彩票中被选中和未被选中的人，并建议使用NIA资金来大大扩展我们的数据收集和分析范围，包括对近老年人（50-64岁）的过度采样，他们的健康风险在许多方面与65岁及以上的人相似，他们很快就会进入医疗保险。我们建议利用这一非凡而独特的机会，解决三个不同领域的问题：第一，保险如何影响医疗保健利用？二、保险对健康有什么影响？第三，健康保险对不同群体的影响有何不同？我们将通过利用三个数据源来回答这些问题：每半年一次的邮件调查、面对面的数据收集工作（包括健康生理标志物的测量）以及医院和急诊室使用的行政记录。公共卫生关系：了解健康保险覆盖范围的后果是中央评估建议，以扩大或修改健康保险覆盖范围在美国拟议的研究将利用一个独特的政策实验正在进行中的俄勒冈州，以评估医疗保健利用和健康结果的因果关系影响的健康保险。