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

BACKGROUND: Uninsured adults in late middle age are more likely to have a health decline than individuals with private insurance.

OBJECTIVE: To determine how health and the risk of future adverse health outcomes changes after the uninsured gain Medicare.

DESIGN: Prospective cohort study.

PARTICIPANTS: 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.

MEASUREMENTS: 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)).

RESULTS: 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.

CONCLUSIONS: 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.

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