Gaining and losing health insurance: Strengthening the evidence for effects on access to care and health outcomes

被引:82
作者
Kasper, JD [1 ]
Giovannini, TA
Hoffman, C
机构
[1] Johns Hopkins Univ, Sch Hyg & Publ Hlth, Baltimore, MD 21218 USA
[2] Mission Neighborhood Hlth Ctr, San Francisco, CA USA
关键词
D O I
10.1177/107755870005700302
中图分类号
R19 [保健组织与事业(卫生事业管理)];
学科分类号
摘要
This study uses longitudinal data to examine the consequences of losing and gaining health insurance coverage for access to care and health. For both Medicaid and privately insured persons, compared with those who remained insured, persons losing coverage over a 2-year period were more likely to lack a usual source of care, encounter difficulty in obtaining medical care, be very dissatisfied with ability to obtain needed care, and report no physician visits in the previous 12 months. Uninsured people who gained coverage showed improvement across all indicators of access, in contrast to those who remained without insurance. The effects of changes in coverage on health were in the same direction as those for access, but did not reach statistical significance. This study strengthens the evidence that health insurance coverage has a substantial impact on ability to gain access to medical care and may affect health status.
引用
收藏
页码:298 / 318
页数:21
相关论文
共 34 条
  • [1] Aday L., 1975, DEV INDICES ACCESS M
  • [2] ADAY LA, 1984, ACCESS MED CARE US H
  • [3] Andersen R, 1968, BEHAV MODEL FAMILIES
  • [4] ANDERSEN R, 1975, 2 DECADES HLTH SERVI
  • [5] BEAUREGARD KM, 1997, AHCPR PUB, V1
  • [6] Access to care: How much difference does Medicaid make?
    Berk, ML
    Schur, CL
    [J]. HEALTH AFFAIRS, 1998, 17 (03) : 169 - 180
  • [7] Can Medicaid managed care provide continuity of care to new Medicaid enrollees? An analysis of tenure on Medicaid
    Carrasquillo, O
    Himmelstein, DU
    Woolhandler, S
    Bor, DH
    [J]. AMERICAN JOURNAL OF PUBLIC HEALTH, 1998, 88 (03) : 464 - 466
  • [8] More offers, fewer takers for employment-based health insurance: 1987 and 1996
    Cooper, PF
    Schone, BS
    [J]. HEALTH AFFAIRS, 1997, 16 (06) : 142 - 149
  • [9] CORNELIUS L, 1991, AHCPR PUB
  • [10] Davis K, 1997, HEALTH SERV RES, V31, P641