Problem drinking as intentional risky behavior: Examining the association between state health insurance coverage and excessive alcohol consumption.
Problem drinking as intentional risky behavior: Examining the association between state health insurance coverage and excessive alcohol consumption.
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饮酒作为故意的冒险行为：研究州健康保险覆盖范围和过度饮酒之间的关联。
DOI：
10.1016/j.pmedr.2021.101556
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发表时间：
2021-12
影响因子：
2.8
通讯作者：
Chaloupka F
中科院分区：
文献类型：
--
作者：
Azagba S;Shan L;Wolfson M;Hall M;Chaloupka F
道德风险理论断言，拥有健康保险可能会增加个人的冒险行为。我们研究了美国成年人中州健康保险覆盖面与过度饮酒之间的关系。我们使用2001-2017年行为风险因素监测系统数据来估计每个州的年度暴饮和重度饮酒率。在多变量回归分析中，我们使用差分差分（DID）模型来评估州一级保险覆盖率与狂欢和酗酒之间的关系。此外，我们评估了潜在的不对称效应以及经济衰退（2001,2008 - 09）是否具有调节效应。在多变量DID分析中，在具有州固定效应的基线分析中（模型1），以及在扩展基线模型以包括州独特时间趋势的分析中（模型2），州总保险覆盖率与酗酒率没有显著相关。在模型1中，重度饮酒也有类似的结果。相比之下，模型2的结果显示健康保险覆盖率与酗酒率之间存在显著关联。然而，我们在分析中将数据限制在BRFSS抽样框架方法改变之前的时期时，发现两种模型中暴饮率和重度饮酒率没有显著关联。研究结果没有显示出不对称效应，在经济衰退期间，健康保险和过度饮酒之间的关联也没有差异。这些发现在很大程度上不支持健康保险可能导致道德风险（冒险行为）的断言，尤其是酗酒
The moral hazard theory asserts that having health insurance may increase individual risk-taking behaviors. We examined the association between state health insurance coverage and excessive alcohol use among U.S. adults. We used 2001–2017 Behavioral Risk Factor Surveillance System data to estimate annual binge and heavy drinking rates for each state. In a multivariable regression analysis, we used difference-in-difference (DID) models to assess the association between state-level insurance coverage and binge and heavy drinking. Additionally, we assess the potential asymmetric effect and whether economic recessions (2001, 2008–09) had a moderation effect. In the multivariable DID analysis, aggregate state insurance coverage was not significantly associated with binge drinking rates in baseline analysis with state-fixed effects (Model 1), and in the analysis that extends the baseline model to include state unique time trend (Model 2). A similar result was found for heavy drinking in Model 1. In contrast, the result showed a significant association between health insurance coverage and heavy drinking rates in Model 2. However, we found no significant association for binge and heavy drinking rates in both models in the analyses restricting data to periods before the methodological change in the BRFSS sampling frame. The results did not show asymmetric effects, and the association between health insurance and excessive alcohol use did not differ during economic recessions. These findings largely do not support assertions that health insurance may lead to moral hazards (risk-taking behaviors), especially binge drinking
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影响因子：
2.1
作者：
Doiron, Denise;Jones, Glenn;Savage, Elizabeth
通讯作者：
Savage, Elizabeth
影响因子：
1.8
作者：
Dong, Yingying
通讯作者：
Dong, Yingying
DOI：
10.1007/s10754-009-9056-4
发表时间：
2009-12-01
期刊：
INTERNATIONAL JOURNAL OF HEALTH CARE FINANCE & ECONOMICS
影响因子：
--
作者：
Dave, Dhaval;Kaestner, Robert
通讯作者：
Kaestner, Robert
影响因子：
2.1
作者：
Cotti, Chad;Nesson, Erik;Tefft, Nathan
通讯作者：
Tefft, Nathan
影响因子：
3.7
作者：
Cotti, Chad;Dunn, Richard A.;Tefft, Nathan
通讯作者：
Tefft, Nathan