Partial-year insurance coverage and the health care utilization of children.

University of Wisconsin-Madison, USA.
Medical Care Research and Review (Impact Factor: 2.57). 12/2008; 66(1):49-67. DOI: 10.1177/1077558708324341
Source: PubMed

ABSTRACT A large literature examines the effects of health insurance on the health care utilization of children; however, most existing studies conceptualize coverage as a point-in-time measure rather than as a dynamic phenomenon. The major contribution of this article is its provision of estimates on the relationship between the duration of coverage over the course of a calendar year and health care utilization among children. Using child-level fixed-effects regression, we find that an incremental uninsured month is associated with a 0.7 percentage point decline in the probability of receiving a visit over the course of a year and a 3% decrease in the number of visits received. Children with intrayear coverage losses are more likely than those with continuous coverage to lose their usual source of care, which serves as a potential mechanism through which short gaps in coverage may lead to longer-term decrements in utilization.

  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Employer-provided insurance is the leading source of medical insurance for non-elderly Americans. However, it leaves many without coverage. Evidence suggests that the non-group insurance market does a poor job of filling in these gaps, for those with both short- and long-term uninsurance. It does so for all income and age groups, as well as for both genders. It does fill some of the gaps in employer-provided coverage for those with middle and high incomes, though very incompletely.
    Journal of Labor Research 12/2009; 30(4):340-349. · 0.20 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Even as the number of children with health insurance has increased, coverage transitions-movement into and out of coverage and between public and private insurance-have become more common. Using data from 1996 to 2005, we examine whether insurance instability has implications for access to primary care. Because unobserved factors related to parental behavior and child health may affect both the stability of coverage and utilization, we estimate the relationship between insurance and the probability that a child has at least one physician visit per year using a model that includes child fixed effects to account for unobserved heterogeneity. Although we find that unobserved heterogeneity is an important factor influencing cross-sectional correlations, conditioning on child fixed effects we find a statistically and economically significant relationship between insurance coverage stability and access to care. Children who have part-year public or private insurance are more likely to have at least one doctor's visit than children who are uninsured for a full year, but less likely than children with full-year coverage. We find comparable effects for public and private insurance. Although cross-sectional analyses suggest that transitions directly between public and private insurance are associated with lower rates of utilization, the evidence of such an effect is much weaker when we condition on child fixed effects.
    International Journal of Health Care Finance and Economics 02/2014; · 0.49 Impact Factor