Title | Health Insurance and Poverty in Trajectories of Out-of-Pocket Expenditure among Low-Income Middle-Aged Adults. |
Publication Type | Journal Article |
Year of Publication | 2018 |
Authors | Kwon, E, Park, SJung, McBride, TD |
Journal | Health Services Research |
Volume | 53 |
Issue | 6 |
Pagination | 4332-4352 |
ISSN Number | 1475-6773 |
Keywords | Low income, Medicare/Medicaid/Health Insurance, Out-of-pocket payments |
Abstract | OBJECTIVE: To assess the effects of longitudinal patterns of health insurance and poverty on out-of-pocket expenditures among low-income late middle-aged adults. DATA SOURCES/STUDY SETTING: Six waves (2002-2012) of the Health and Retirement Study, in combination with RAND Center for the Study of Aging data, were used. STUDY DESIGN: A random coefficient regression analysis was conducted in a multilevel growth curve framework to estimate the impact of health insurance and poverty on out-of-pocket expenditures. PRINCIPAL FINDINGS: At baseline, individuals with private insurance or unstable coverage were more likely to have out-of-pocket expenditures and financial burdens than public insurance holders. Over time, the poor who had no insurance, unstable coverage, or insurance type change had higher out-of-pocket expenditures; private coverage holders had higher odds of financial burden. CONCLUSIONS: Unstable insurance coverage had a discernible effect on the long-term, out-of-pocket expenditures among low-income adults. Findings have an important policy implication to protect poor late middle-aged population; as this population enters old age, the high financial burden it faces may exacerbate persistent socioeconomic health disparity among older people with unstable insurance coverage. |
DOI | 10.1111/1475-6773.12974 |
User Guide Notes | |
Alternate Journal | Health Serv Res |
Citation Key | 9634 |
PubMed ID | 29770438 |
PubMed Central ID | PMC6232446 |
Grant List | P30 DK092950 / DK / NIDDK NIH HHS / United States |