Spillover Effects of Community Uninsurance on Working-age Adults and Seniors
An Instrumental Variables Analysis
Bibliographic Data
| ID | 9101430 |
|---|---|
| Authors | Carole Roan Gresenz (0000-0002-7381-7914, RAND Corporation, corresponding author), José J Escarce (RAND Corporation) |
| Year | 2011 |
| Volume | 49 |
| Issue | 9 |
| Pages | e14-e21 |
| Publication date | 2011-09-01 |
| Peer Reviewed | Yes |
| Open Access | No |
| Type | ARTICLE |
| Venue | Medical Care (JOURNAL) |
| Journal identifiers | ISSN: 0025-7079 • E-ISSN: 1537-1948 |
| Publisher | Ovid Technologies (Wolters Kluwer Health) (PUBLISHER) |
| DOI | 10.1097/mlr.0b013e31822dc7f4 |
| PMID | 21865890 |
| OpenAlex | W1989151874 |
| Language | EN |
| Citations received | 7 |
| References cited | 19 |
BACKGROUND: : Previous research suggests, but does not definitively establish, that a high level of uninsurance in a community may negatively affect access to and quality of health care for insured persons. OBJECTIVE: : To assess the effect of the level of uninsurance in a community on access to and satisfaction with care-an important dimension of quality-among insured persons. RESEARCH DESIGN: : The 1996 to 2006 Medical Expenditure Panel Survey Household Component data linked to data from the Current Population Survey, Area Resource File, and the InterStudy Competitive Edge. Analyses include 86,928 insured adult respondents living in approximately 200 large metropolitan areas. MAIN OUTCOME MEASURES: : Measures of whether an individual had a usual source of care, had any delay/difficulty obtaining needed care, used office-based services, used prescription drug services, and used any medical services, and measures of satisfaction with care. RESULTS: : Among privately insured adults, a higher community uninsurance rate resulted in a lower probability of having a usual source of care, having an office-based visit, having any medical expenditures, and reporting being satisfied with the quality of care provided by the usual source of care. A higher community uninsurance rate also led to a higher probability of reporting difficulty obtaining needed care. Among Medicare enrollees, a higher community uninsurance rate resulted in lower reported satisfaction with care and higher probability of experiencing difficulty or delay in getting needed care. CONCLUSIONS: : Our results suggest substantial spillover effects of the community uninsurance rate on access to and satisfaction with health care among insured working-age adults and seniors. Consequently, new efforts to address the problem of the uninsured may bring significant benefits to persons who already have insurance
Affect (linguistics) · Environmental health · Family medicine · Health care · Health insurance · Medical care · Medical Expenditure Panel Survey · Medical prescription · National Health Interview Survey · Population · Prescription drug · Quality (philosophy) · Spillover effect · Survey data collection · Healthcare Policy and Management · Healthcare Systems and Reforms · Medicine · Nursing · Primary Care and Health Outcomes · Psychology · Gerontology
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Impact of Changes in Medicaid Coverage on Physician Provision of Safety Net Care
Health Care Experiences of Latino Children in Emerging and Traditional Destinations
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Spillover Effects of an Uninsured Population
Beyond Health Effects
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Societal and Individual Determinants of Medical Care Utilization in the United States
Problems with Instrumental Variables Estimation when the Correlation between the Instruments and the Endogenous Explanatory Variable is Weak
Access to Medical Care for Low-Income Persons
Societal and Individual Determinants of Medical Care Utilization in the United States
Large Sample Properties of Generalized Method of Moments Estimators
Specification Tests in Econometrics
Instrumental Variables Regression with Weak Instruments
What Accounts for Differences in Uninsurance Rates across Communities
Access to Health Care for Older Persons in the United States
The effect of local primary care physician supply on the utilization of preventive health services in the United States
Effects of Managed Care on the Length of Time That Elderly Patients Spend With Physicians During Ambulatory Visits
Revisiting the Behavioral Model and Access to Medical Care
| Unique citing works | 7 |
|---|---|
| Citations per year | 0.54 |
| Citation span | 2013 - 2025 (13) |
| Citation velocity | recent |
| Highly cited | No |
| Citation types | Neutral: 7 |