Massachusetts coverage expansion associated with reduction in primary care utilization among Medicare beneficiaries.
Objective: To examine whether expanding coverage for the nonelderly affects primary care utilization among Medicare beneficiaries.Data Source: Zip code-level files from Dartmouth Atlas for Massachusetts and surrounding states, including Medicare utilization for 2005 (pre expansion) and 2007 (post ex...
| Publicado en: | Health Services Research Vol. 48; no. 6pt1; pp. 1826 - 1840 |
|---|---|
| Autores principales: | , |
| Formato: | research Journal Article |
| Publicado: |
Wiley-Blackwell
Dec2013
|
| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=104120017&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 104120017 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 00179124 HSR jtl: Health Services Research issn: 00179124 maglogo: Y pubinfo: dt: Dec2013 vid: 48 iid: 6pt1 pid: 480 pub: Wiley-Blackwell place: Malden, Massachusetts artinfo: ui: 104120017 NLM24117239 2012400090 10.1111/1475-6773.12103 NLM24117239 104120017 ppf: 1826 ppct: 14 formats: tig: atl: Massachusetts coverage expansion associated with reduction in primary care utilization among Medicare beneficiaries. aug: au: Bond, Amelia M White, Chapin affil: The Wharton School, University of Pennsylvania, Philadelphia, PA. sug: subj: Medicare Statistics and Numerical Data Primary Health Care Utilization Insurance, Health Statistics and Numerical Data Aged Health Care Reform Health Services Accessibility Statistics and Numerical Data Human Massachusetts Cluster Analysis Socioeconomic Factors United States Aged: 65+ years ab: Objective: To examine whether expanding coverage for the nonelderly affects primary care utilization among Medicare beneficiaries.Data Source: Zip code-level files from Dartmouth Atlas for Massachusetts and surrounding states, including Medicare utilization for 2005 (pre expansion) and 2007 (post expansion), and health insurance coverage for 2005.Study Design: We use two zip code-level outcomes: arc percent change in primary care visits per Medicare beneficiary per year, and percentage point change in the share of beneficiaries with one or more primary care visits. We use a regression-based difference-in-difference analysis that compares Massachusetts with surrounding states, and zip codes with high, medium, and low uninsurance rates in 2005. The 2005 uninsurance rates correspond to the size of Massachusetts' coverage expansion. We use propensity scores for identification of comparable zip codes and for weighting.Principal Findings: In areas of Massachusetts with the highest uninsurance rates-where insurance expansion had the largest impact-visits per beneficiary fell 6.9 percent (p < .001) relative to areas of Massachusetts with the smallest uninsurance rates.Conclusions: The expansion of coverage for the nonelderly reduced primary care visits, but it did not reduce the percent of beneficiaries with at least one visit. These results could imply restricted access, increased efficiency, or some blend. pubtype: Academic Journal doctype: research Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
|---|