Changes in health for the uninsured after reaching age-eligibility for Medicare.

TitleChanges in health for the uninsured after reaching age-eligibility for Medicare.
Publication TypeJournal Article
Year of Publication2006
AuthorsBaker, DW, Feinglass, J, Durazo-Arvizu, R, Witt, WP, Sudano, JJ, Thompson, JA
JournalJ Gen Intern Med
Volume21
Issue11
Pagination1144-9
Date Published2006 Nov
ISSN Number1525-1497
Call Numbernewpubs20070125_Baker_etal_JGIM
KeywordsAge Factors, Aged, Cohort Studies, Eligibility Determination, Female, Health Status, Humans, Male, Medically Uninsured, Medicare, Middle Aged, Prospective Studies, United States
Abstract

<p><b>BACKGROUND: </b>Uninsured adults in late middle age are more likely to have a health decline than individuals with private insurance.</p><p><b>OBJECTIVE: </b>To determine how health and the risk of future adverse health outcomes changes after the uninsured gain Medicare.</p><p><b>DESIGN: </b>Prospective cohort study.</p><p><b>PARTICIPANTS: </b>Participants (N=3,419) in the Health and Retirement Study who transitioned from private insurance or being uninsured to having Medicare coverage at the 1996, 1998, 2000, or 2002 interview.</p><p><b>MEASUREMENTS: </b>We analyzed risk-adjusted changes in self-reported overall health and physical functioning during the transition period to Medicare (t(-2) to t(0)) and the following 2 years (t(0) to t(2)).</p><p><b>RESULTS: </b>Between the interview before age 65 (t(-2)) and the first interview after reaching age 65 (t(0)), previously uninsured individuals were more likely than those who had private insurance to have a major decline in overall health (adjusted relative risk [ARR] 1.46; 95% confidence interval [CI] 1.03 to 2.04) and to develop a new physical difficulty affecting mobility (ARR 1.24; 95% CI 0.96 to 1.56) or agility (ARR 1.33; 95% CI 1.12 to 1.54). Rates of improvement were similar between the 2 groups. During the next 2 years (t(0) to t(2)), adjusted rates of declines in overall health and physical functioning were similar for individuals who were uninsured and those who had private insurance before gaining Medicare.</p><p><b>CONCLUSIONS: </b>Gaining Medicare does not lead to immediate health benefits for individuals who were uninsured before age 65. However, after 2 or more years of continuous coverage, the uninsured no longer have a higher risk of adverse health outcomes.</p>

URLhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC1831646/
DOI10.1111/j.1525-1497.2006.00576.x
User Guide Notes

http://www.ncbi.nlm.nih.gov/pubmed/16879704?dopt=Abstract

Alternate JournalJ Gen Intern Med
Citation Key7098
PubMed ID16879704
PubMed Central IDPMC1831646
Grant ListR01 HS010283 / HS / AHRQ HHS / United States
2R01 HS10283 / HS / AHRQ HHS / United States