Dental Coverage Transistions, Utilization and Retirement

牙科保险的过渡、利用和退休

• 批准号: 7985910
• 负责人: RICHARD J MANSKI
• 金额: $ 38.97万
• 依托单位: UNIVERSITY OF MARYLAND BALTIMORE
• 依托单位国家: 美国
• 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
• 来源: https://reporter.nih.gov/project-details/7985910
• 关键词: Address; Adult; Affect; Age; Agreement; American; Award; Behavior; Budgets; Characteristics; Complement; Data; Data Files; Dental; Dental Care; Dental Insurance; Dentists; Dentures; Development; Drug Formulations; Eating; Elderly; Expenditure; Experimental Designs; Foundations; Frequencies; Goals; Grant; Health; Health Status; Household; Individual; Institutes; Insurance Coverage; Interdisciplinary Study; Jaw; Marketing; Medicaid; Medicare; Methodology; Methods; Michigan; Oral health; Paper; Periodicity; Persons; Policies; Policy Maker; Population; Preventive; Private Sector; Procedures; Progress Reports; Questionnaires; Reader; Reporting; Research; Research Institute; Retirement; Self Assessment; Source; Surveys; Testing; Time; Tooth structure; Uninsured; Universities; Update; Visit; Work; design; health care service utilization; improved; innovation; parent project; payment; public health relevance; social

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覆盖范围和牙科使用之间的关系，并随后提供必要的信息，以帮助决策者考虑将牙科覆盖范围纳入Medicare、Medigap和Medicaid计划，或作为退休后覆盖范围在私营部门的延伸。该项目是一个多学科研究团队的共同努力，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。具体来说，这个项目将：1.估计51岁及以上退休后继续参加牙科保险、退休后没有保险、退休后失去保险或退休后获得保险的人的数量和特征。针对这一特定目标的工作假设是，人们在退休后不太可能获得牙科保健保险。2.估计牙科护理使用情况作为牙科护理覆盖状况和过渡期的函数，以控制个人和家庭特征以及逆向选择。这一特定目的的工作假设是，没有牙科保健保险的人不太可能去看牙医。3A.估计牙科护理的自付支出，作为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的函数。关于这一特定目的的工作假设是，有牙科就诊的退休和/或没有牙科保险的人将有更高的自付支出。3B.估计牙科护理自付支出的变化，作为牙科护理覆盖范围和退休过渡的函数，控制个人和家庭特征以及逆向选择。关于这一特定目的的工作假设是，有牙科就诊的人退休和/或没有牙科保险将有更高的自付支出。4.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，控制个人和家庭特征以及逆向选择。工作假说是，较低的净财富水平和净财富减少与较少的牙科保健利用率和覆盖率以及使用牙科保健的人更高的自付费用有关。5.按牙科程序类型估计牙科护理使用情况，作为口腔健康和牙科护理覆盖面状况的函数，控制个人和家庭特征和不良选择。这一特定目的的工作假设是，牙科覆盖导致定期的预防性牙科护理，改善口腔健康，并减少昂贵的非预防性程序的需要。6.估计51岁及以上报告牙科护理覆盖面的人数和特征，其中牙科使用率异常低，和/或牙科使用者自付费用异常高。针对这一特定目的的工作假设是，这些群体更有可能期望医疗保险包括牙科保险，因此误报有牙科保险。该项目的成果将协助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补助计划，将成人牙科护理全面纳入医疗补助计划，并将退休后延续保险范围扩大到包括私营部门的牙科保险。 公共卫生相关性：该项目的目标是更好地了解老年人的牙科保健覆盖范围和牙齿使用之间的关系，并随后提供必要的信息，以帮助决策者考虑将牙科覆盖范围纳入联邦医疗保险、医疗补助计划和医疗补助计划，或将其作为退休后覆盖范围在私营部门的延伸。