Title | The health effects of Medicare for the near-elderly uninsured. |
Publication Type | Journal Article |
Year of Publication | 2009 |
Authors | Polsky, D, Doshi, JA, Escarce, JJ, Manning, W, Paddock, SM, Cen, L, Rogowski, J |
Journal | Health Serv Res |
Volume | 44 |
Issue | 3 |
Pagination | 926-45 |
Date Published | 2009 Jun |
ISSN Number | 1475-6773 |
Call Number | newpubs20090908_Polsky_etal.pdf |
Keywords | Aged, Attitude to Health, Female, Follow-Up Studies, Health Services Accessibility, Health Services Research, Health Status, Health Surveys, Humans, Insurance Coverage, Logistic Models, Male, Medically Uninsured, Medicare, Mortality, Multivariate Analysis, Program Evaluation, Retirement, Socioeconomic factors, Statistics, Nonparametric, United States |
Abstract | OBJECTIVE: To determine whether Medicare enrollment at age 65 has an effect on the health trajectory of the near-elderly uninsured. DATA SOURCES: Eight biennial waves (1992-2006) of the Health and Retirement Study, a nationally representative panel survey of noninstitutionalized 51-61 year olds and their spouses. STUDY DESIGN: We use a quasi-experimental approach to compare the health effects of insurance for the near-elderly uninsured with previously insured contemporaneous controls. The primary outcome measure is overall self-reported health status combined with mortality (i.e., excellent to very good, good, fair to poor, dead). RESULTS: The change in the trajectory of overall health status for the previously uninsured that can be attributed to Medicare is small and not statistically significant. For every 100 persons in the previously uninsured group, joining Medicare is associated with 0.6 fewer in excellent or very good health (95 percent CI: -4.8, 3.3), 0.3 more in good health (95 percent CI: -3.8, 4.1), 2.5 fewer in fair or poor health (95 percent CI: -7.4, 2.3), and 2.8 more dead (-4.0, 10.0) by age 73. The health trajectory patterns from physician objective health measures are similarly small and not statistically significant. CONCLUSIONS: Medicare coverage at age 65 for the previously uninsured is not linked to improvements in overall health status. |
DOI | 10.1111/j.1475-6773.2009.00964.x |
User Guide Notes | |
Endnote Keywords | Medicare/health status/Health Insurance/Health Benefits |
Endnote ID | 16770 |
Alternate Journal | Health Serv Res |
Citation Key | 7304 |
PubMed ID | 19674430 |
PubMed Central ID | PMC2699915 |
Grant List | R01 AG024451 / AG / NIA NIH HHS / United States R01 AG024451-01 / AG / NIA NIH HHS / United States |