Differential Loss to Follow-up by Insurance Status in the Health and Retirement Study: Implications for National Estimates on Health Insurance Coverage

As a nationally representative cohort of middle-aged and elderly adults with longitudinal data spanning nearly two decades, the Health and Retirement Study (HRS) is an important resource for researchers studying the dynamics of health insurance coverage in the United States and the relation of insurance coverage to the use of health services and to health outcomes. We assessed the strengths and limitations of currently available HRS data for such research, focusing on survey items in these domains and Medicare claims data that have been linked to HRS survey data. The process for researchers to obtain Medicare claims has greatly improved in recent years. The additions of biomarkers (e.g. blood pressure and serum cholesterol) and objective measures of physical functioning for HRS participants have also been notable improvements. We propose changes to the HRS to enhance its value for health services research, particularly regarding the effects of health care reform as the Patient Protection and Affordable Care Act of 2010 is implemented over the next decade.

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Geographic variation in health insurance coverage : United States, 2019

10.15620/cdc:107558 ◽

2021 ◽

Author(s):

Robin A. Cohen ◽

◽

Emily P. Terlizzi ◽

Amy E. Cha ◽

Michael E. Martinez ◽

...

Keyword(s):

Public Health ◽

United States ◽

Health Insurance ◽

Geographic Variation ◽

Private Health Insurance ◽

Insurance Coverage ◽

Health Insurance Coverage ◽

Public Health Insurance ◽

National Estimates ◽

State Regional

This report presents state, regional, and national estimates of the percentage of persons who were uninsured, had private health insurance coverage, and had public health insurance coverage in 2019.

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Impact of local health insurance schemes on primary care management and control of hypertension: a cross-sectional study in Shenzhen, China

BMJ Open ◽

10.1136/bmjopen-2019-031098 ◽

2019 ◽

Vol 9 (10) ◽

pp. e031098 ◽

Cited By ~ 1

Author(s):

Haitao Li ◽

Zhu Wu ◽

Xia Hui ◽

Yanhong Hu

Keyword(s):

Primary Care ◽

Social Capital ◽

Health Insurance ◽

Insurance Coverage ◽

Health Insurance Coverage ◽

Hypertension Management ◽

Insurance Status ◽

Local Health ◽

Hypertensive Patients ◽

And Control

BackgroundIn China, the local health insurance coverage is usually related to timely reimbursement of hypertensive care in primary care settings, while health insurance that is not local could represent an obstacle for accessibility and affordability of primary care for hypertensive patients.ObjectiveTo investigate whether local health insurance schemes have a positive impact on hypertension management and control.DesignWe performed an on-site, face-to-face, patients survey in community health centres (CHCs) in Shenzhen, China.Setting and participantsHypertensive patients seeking healthcare from CHCs were selected as study participants using a systematic sampling design.Main measuresWe obtained information about insurance status, social capital, drug treatment and control of hypertension. Multivariable stepwise logistic regression models were constructed to test the associations between insurance status and hypertension management, as well as insurance status and social capital.ResultsA total of 867 participants were included in the final study analysis. We found that the participants covered by local insurance schemes were more likely to be managed in primary care facilities (61.1% vs 81.9%; OR=2.58, 95% CI: 1.56 to 4.28), taking antihypertensive drugs (77.2% vs 88.0%; OR=2.23, 95% CI: 1.37 to 3.62) and controlling blood pressure (43.0% vs 52.4%; OR=1.46, 95% CI: 1.03 to 2.07) when compared with those with insurance coverage that is not local. The participants covered by local insurance schemes reported a higher score of perceived generalised trust than those without (4.23 vs 3.97; OR=0.74, 95% CI: 0.53 to 0.86).ConclusionOur study demonstrates that local health insurance coverage could help improve management and control of hypertension in a primary care setting. Policymakers suggest initiating social interventions for better management and control of hypertension at the primary care level, although the causal pathways across insurance status, social capital and control of hypertension deserve further investigations.

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Accuracy in Self-Reported Health Insurance Coverage among Medicaid Enrollees

INQUIRY The Journal of Health Care Organization Provision and Financing ◽

10.5034/inquiryjrnl_45.04.438 ◽

2008 ◽

Vol 45 (4) ◽

pp. 438-456 ◽

Cited By ~ 13

Author(s):

Kathleen Thiede Call ◽

Gestur Davidson ◽

Michael Davern ◽

E. Richard Brown ◽

Jennifer Kincheloe ◽

...

Keyword(s):

Health Insurance ◽

Multivariate Analyses ◽

Insurance Coverage ◽

Health Insurance Coverage ◽

Insurance Status ◽

Related Factors ◽

Reporting Error ◽

Reported Health

The largest portion of the Medicaid undercount is caused by survey reporting error—that is, Medicaid recipients misreport their enrollment in health insurance coverage surveys. In this study, we sampled known Medicaid enrollees to learn how they respond to health insurance questions and to document correlates of accurate and inaccurate reports. We found that Medicaid enrollees are fairly accurate reporters of insurance status and type of coverage, but some do report being uninsured. Multivariate analyses point to the prominent role of program-related factors in the accuracy of reports. Our findings suggest that the Medicaid undercount should not undermine confidence in survey-based estimates of uninsurance.

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Progression of mild cognitive impairment to dementia in German specialist practices

Dementia ◽

10.1177/1471301216673919 ◽

2016 ◽

Vol 18 (1) ◽

pp. 380-390 ◽

Cited By ~ 2

Author(s):

Jens Bohlken ◽

Louis Jacob ◽

Karel Kostev

Keyword(s):

Cognitive Impairment ◽

Health Insurance ◽

Mild Cognitive Impairment ◽

Cox Regression ◽

Insurance Coverage ◽

Age Groups ◽

Health Insurance Coverage ◽

Hazard Ratio ◽

Age Group

The goal of this study was to estimate the rate of the progression of mild cognitive impairment to dementia and identify the potential risk factors in German specialist practices from 2005 to 2015. This study included 4633 patients aged 40 years and over from 203 neuropsychiatric practices, who were initially diagnosed with mild cognitive impairment between 2005 and 2013. The primary outcome was diagnosis of all-cause dementia recorded in the database until the end of the five-year follow-up period. Cox regression models were used to examine mild cognitive impairment progression to dementia when adjusted for confounders (age, sex, and health-insurance type). The mean age was 68.9 years and 46.6% were men. After the five-year follow-up period, 38.1% of women and 30.4% of men had been diagnosed with dementia ( p < 0.001). The share of subjects with dementia increased with age, rising from 6.6% in the age group of ≤ 60 years to 64.7% in the age group of > 80 years ( p < 0.001). Men were at a lower risk of being diagnosed with dementia than women (hazard ratio = 0.86). Patients in the age groups 61–70, 71–80, and > 80 years also had a higher risk of developing this psychiatric disorder, with hazard ratios ranging from 3.50 to 11.71. Finally, mild cognitive impairment was less likely to progress to dementia in people with private health-insurance coverage than in people with public health-insurance coverage (hazard ratio = 0.69). Around one in three patients developed dementia in the five years following mild cognitive impairment diagnosis. Sex, age, and type of health insurance were associated with this risk.

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Association Between Health Insurance and Race With Mortality From Trauma: a Retrospective Study

10.21203/rs.3.rs-546029/v1 ◽

2021 ◽

Author(s):

Ibrahim Gwarzo ◽

Maria Perez-Patron ◽

Xiaohui Xu ◽

Tiffany Radcliff ◽

Jennifer Horney

Keyword(s):

Health Insurance ◽

Trauma Registry ◽

Insurance Coverage ◽

Health Insurance Coverage ◽

Registry Data ◽

Insurance Status ◽

Health Insurance Status ◽

Trauma Mortality ◽

Race Ethnicity ◽

Related Mortality

Abstract Background: The population health implications of the growing burden of trauma-related mortality may be influenced by access to health insurance coverage, and demographic characteristics such as race and ethnicity. We investigated the effects of health insurance status and race/ethnicity on the risk of mortality among trauma victims in Texas.Methods: Using Texas trauma registry data from 2014 - 2016, we categorized health insurance coverage into private, public, and uninsured, and categorized patients with serious injuries into Non-Hispanic Whites, Non-Hispanic Blacks, Hispanics Any-Race, and Others. Multivariate logistic regression was used to estimate the effects of health insurance status and race/ethnicity on mortality, controlling for age, gender, severity of the trauma, cause of trauma, presence of comorbid conditions, trauma center designation, presence of a traumatic brain injury (TBI), and severity of a TBI. Results: From January 1, 2014, to December 31, 2016, there were 415,159 trauma cases in Texas; 8,827 (2.1%) were fatal. Among patients with at least a moderate injury, 24, 606 (17.4%) were uninsured, and 98, 237 (69.4%) identified as Non-Hispanic White. In the multivariate analysis, Hispanics of any race and Non-Hispanic Blacks had higher adjusted odds of trauma mortality compared to Non-Hispanic Whites [ORHispanics= 1.25: 95% CI (1.16 – 1.36)] [ORBlacks= 2.11: 95% CI (1.87 – 2.37)]. Similarly, compared to privately insured, uninsured patients had 86% higher odds of trauma-related death [OR= 1.86: 95% CI (1.66 – 2.05)]. The effects of lack of health insurance on trauma mortality varied across race/ethnicity of the victims; uninsured Non-Hispanic Blacks had disproportionately higher adjusted odds of trauma mortality than uninsured Whites. Conclusion: Using Texas trauma registry data, we found significant disparities in trauma-related mortality risk based on race/ethnicity and health insurance coverage. The identification of trauma mortality inequalities could inform the design and implementation of future public health interventions.

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Geographic Variation in Health Insurance Coverage: United States, 2020

10.15620/cdc:112968 ◽

2022 ◽

Author(s):

Emily Terlizzi ◽

Robin Cohen

Keyword(s):

Public Health ◽

United States ◽

Health Insurance ◽

Geographic Variation ◽

Private Health Insurance ◽

Insurance Coverage ◽

Health Insurance Coverage ◽

Public Health Insurance ◽

National Estimates ◽

State Regional

This report presents state, regional, and national estimates of the percentage of people who were uninsured, had private health insurance coverage, and had public health insurance coverage at the time of the interview.

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