Dental Coverage Transistions, Utilization and Retirement

描述（由申请人提供）：该项目的目标是更好地了解老年人牙科保健覆盖率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医疗保险、医疗保险和医疗补助计划，或作为私营部门退休后保险的延伸。该项目是一个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研究。具体来说，这个项目将：1。估计51岁及以上退休后仍然有牙科保险、退休后没有保险、退休后失去保险或退休后获得保险的人数和特征。针对这一具体目标的工作假设是，人们在退休后不太可能有牙科保健保险。2. 估计牙科保健使用作为控制个人和家庭特征和逆向选择的牙科保健覆盖状态和过渡的函数。针对这一具体目标的工作假设是，没有牙科保健保险的人不太可能去看牙医。3 a。估计牙科保健自付费用作为牙科保健覆盖和退休状态的函数，控制个人和家庭特征和逆向选择的过渡。这一具体目标的工作假设是，退休和/或没有牙科保险的人去看牙医会有更高的自付费用。3 b。估计牙科保健自付费用的变化，作为牙科保健覆盖和退休过渡的函数，控制个人和家庭特征和逆向选择。针对这一具体目标的工作假设是，退休和/或没有牙科保险的人将有更高的自付费用。4. 在控制个人和家庭特征和逆向选择的情况下，估计牙科保健使用、覆盖范围和自付费用与净财富状况和过渡之间的关系。工作假设是，较低水平的净财富和减少与较低的牙科保健使用率和覆盖面以及较高的牙科保健自付费用有关。5. 估计牙科保健使用的牙科手术类型作为口腔健康和牙科保健覆盖状况的功能，控制个人和家庭特征和逆向选择。针对这一具体目标的工作假设是，牙科保险促使人们定期进行预防性牙科护理，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岁及以上报告牙科保健覆盖率非典型低水平牙科使用和/或非典型高水平自费牙科使用的人的数量和特征。针对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括在医疗保险中，因此错误地报告了牙科保险。该项目的成果将有助于政策制定者制定政府政策，包括提议将医疗保险扩大到包括牙科保险，将牙科保险纳入医疗保险计划，将成人牙科保健全面覆盖纳入医疗补助计划，以及将退休后继续覆盖扩大到包括私营部门的牙科保险。

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.