Health service use among the previously uninsured: is subsidized health insurance enough?

TitleHealth service use among the previously uninsured: is subsidized health insurance enough?
Publication TypeJournal Article
Year of Publication2012
AuthorsDecker, SL, Doshi, JA, Knaup, AE, Polsky, D
JournalHealth Econ
Volume21
Issue10
Pagination1155-68
Date Published2012 Oct
ISSN Number1099-1050
KeywordsAged, Female, Health Care Surveys, Health Services, Health Status, Humans, Insurance Coverage, Insurance, Health, Male, Medically Uninsured, Medicare, Middle Aged, Socioeconomic factors, United States
Abstract

Although it has been shown that gaining Medicare coverage at age 65 years increases health service use among the uninsured, difficulty in changing habits or differences in the characteristics of previously uninsured compared with insured individuals may mean that the previously uninsured continue to use the healthcare system differently from others. This study uses Medicare claims data linked to two different surveys--the National Health Interview Survey and the Health and Retirement Study--to describe the relationship between insurance status before age 65 years and the use of Medicare-covered services beginning at age 65 years. Although we do not find statistically significant differences in Medicare expenditures or in the number of hospitalizations by previous insurance status, we do find that individuals who were uninsured before age 65 years continue to use the healthcare system differently from those who were privately insured. Specifically, they have 16% fewer visits to office-based physicians but make 18% and 43% more visits to hospital emergency and outpatient departments, respectively. A key question for the future may be why the previously uninsured seem to continue to use the healthcare system differently from the previously insured. This question may be important to consider as health coverage expansions are implemented.

DOI10.1002/hec.1780
User Guide Notes

http://www.ncbi.nlm.nih.gov/pubmed/22945812?dopt=Abstract

Endnote Keywords

Medicare/health Services/ utilization/health Services/ utilization/health Insurance/Uninsured people/Public policy

Endnote ID

69654

Alternate JournalHealth Econ
Citation Key7758
PubMed ID22945812
PubMed Central IDPMC3886823
Grant ListR01 AG024451 / AG / NIA NIH HHS / United States
R01 AG024451-01 / AG / NIA NIH HHS / United States