Designing an Optimal Financing Mechanism for Dental Care Among the Elderly: Reducing the Costs Associated with Information Assymmetries

在这个项目中，我们将记录与向65岁及以上的个人提供牙科保健的各种筹资机制有关的费用和健康结果。此外，我们将分析现有融资机制的成本效益，以及为这项研究开发的额外机制，以向老年人提供牙科护理。评估融资机制的关键是了解信息不对称的作用，信息不对称可以推高保险费，导致购买的保险数量和牙科服务的利用率低于社会最优。该项目的基本框架是一个优化模型，使接受初级和二级预防的牙科服务的总成本最小化，使其达到最高可行值。我们将使用该优化模型来比较现有的牙科保健融资机制以及本研究设计的混合机制和新机制。许多人认为，由于成本持续上升以及穷人和富人之间在健康状况和接受预防保健方面的差距，美国的保健服务提供处于危机关头。老年人保健服务的一个经常被忽视的领域是牙科保健，其通货膨胀率最近超过了医疗保健的通货膨胀率。每年大约有610亿美元花在牙齿护理上。在这项研究中，我们将估计缺乏牙科保险对疾病的影响，确定各种形式的健康分配的有效性，制定改善这种分配的策略，并设计一个框架来分析可能推广到其他医疗保健领域的成本。例如，随着老年人医疗保健费用的增加，扩大医疗保险覆盖范围的压力将越来越大，例如处方药。然而，老年人有一些独特的特点，这可能会使分配困难。低收入人群也存在许多类似的问题。

In this project, we will document costs and health outcomes associated with various financing mechanisms for delivering dental care to individuals age 65 and above. In addition we will analyze the cost-effectiveness of existing financing mechanisms and additional mechanisms developed for this research to deliver dental care to the elderly. Key to evaluation of financing mechanisms is an understanding of the roles of information asymmetries, which can drive up insurance premiums and result in the less than the socially optimal quantity of insurance purchased and utilization of dental services. The basic framework of the project is an optimization model that minimizes the total cost of dental services subject to receipt of primary and secondary prevention equaling its highest feasible value. We will use this optimization model to compare existing financing mechanisms for dental care as well as hybrid and new mechanisms designed in this research.The delivery of health services in the United States is considered by many to be at a crisis point due to both the continued rising costs and disparities in the health status and receipt of preventive care between the poor and wealthy. One area of health service for the elderly that is often ignored is dental care where the rate of inflation has recently outpaced the medical care inflation rate. Approximately $61 billion is spent annually on dental care. In this research we will estimate the impact that the lack of dental insurance has on disease, determine how effective various forms of health allocation are, develop strategies to improve this allocation, and design a framework to analyze costs which may be generalized to other areas of health care. For example, as health care costs incurred by the elderly increase, there will be increasing pressure to extend Medicare coverage, e.g. prescription drugs. However, there are unique characteristics to the elderly that may make allocation difficult. Many similar issues exist for the low-income population.