The Role Of Health Insurance Coverage In Reducing Racial/Ethnic Disparities In Health Care

Background:Item allocation (the assignment of plausible values to missing or illogical responses insurvey studies) is at times necessary in the production of complete data sets. In the American Community Survey(ACS), missing responses to health insurance coverage questions are allocated. Objectives:Because allocationrates may vary as a function of compositional characteristics, this project investigates how seven different healthinsurance coverage items vary in their degree of allocation along basic demographic variables. Methods: Datafrom the ACS 2010 1-year Public Use Microdata Sample file are used in a logistic regression model and tocalculate allocations rates. Results:The findings reveal that: males; people aged 65 and older; those who speakEnglish “very well” or “well”; US citizens; those out-of-poverty; and all racial/ethnic minority groups havehigher odds of experiencing a health insurance item allocation relative to their counterparts. Conclusions: Sincehealth insurance coverage allocations vary by demographic characteristics, further research is needed toinvestigate their mechanisms of missingness and how these may have implications for frailty related research.

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Correlates of health care access problems among reproductive age women in Ethiopia: In-depth analysis of 2016 Ethiopia demographic Health Survey

10.21203/rs.2.14127/v1 ◽

2019 ◽

Author(s):

koku Tamirat ◽

Zemenu Tadesse Tessema ◽

Fentahun Bikale Kebede

Keyword(s):

Health Care ◽

Health Insurance ◽

Health Care Access ◽

Insurance Coverage ◽

Health Insurance Coverage ◽

Reproductive Age ◽

Rural Residence ◽

Factors Associated ◽

Care Access ◽

Reproductive Age Women

Abstract Background Health care access is timely use of personal health services to achieve best health outcomes. Difficulties to access health care among reproductive age women may led to different negative health outcomes to death and disability. Therefore, this study aimed to assess factors associated with problems of accessing health care among reproductive age women in Ethiopia.Method This study was based on 2016 Ethiopia Demography and Health Survey. Individual women record (IR) file was used to extract the dataset and 15, 683 women were included in the final analysis. A composite variable of problem of accessing health care were created from four questions used to rate problem of accessing health care among reproductive age women. Generalized estimating equation (GEE) model was fitted to identify factors associated with problem of accessing health care. Crude and Adjusted odds ratio with a 95%CI computed to assess the strength of association between independent and outcome variables.Result In this study the magnitude of problem in accessing health care among reproductive age women was 69.9% of with 95%CI (69.3 to 70.7). Rural residence (AOR= 2.13, 95%CI: 1.79 to 2.53), women age 35-49 years (AOR= 1.24, 95%CI: 1.09 to 1.40), married/live together (AOR= 0.72, 95%CI: 0.64 to 0.81), had health insurance coverage (AOR=0.83, 95%CI: 0.70 to 0.95), wealth index [middle (AOR=0.75,95%CI: 0.66 to 0.85) and rich (AOR=0.47,95%CI:0.42 to 0.53)], primary education(AOR= 0.80, 95%CI: 0.73 to 0.88), secondary education (AOR= 0.57, 95%CI:0.50 to 0.64) and diploma and higher education (AOR= 0.43, 95%CI: 0.37 to 0.50) were factors associated with problem of health care access among reproductive age women.Conclusion Despite better coverage of health system, problems of health care access among reproductive age women were considerably high. Health insurance coverage, middle and rich wealth, primary and above educational level were negatively associated with problems health care access. In contrast, older age and rural residence were positively associated with problems of health care access among reproductive age women. This suggests that further interventions are necessary to increase universal reproductive health care access for the achievement of sustainable development goals.

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Holes in the Health Insurance System-Who Lacks Coverage and Why

The Journal of Law Medicine & Ethics ◽

10.1111/j.1748-720x.2004.tb00148.x ◽

2004 ◽

Vol 32 (3) ◽

pp. 390-396 ◽

Cited By ~ 3

Author(s):

Catherine Hoffman ◽

Diane Rowland ◽

Alicia L. Carbaugh

Keyword(s):

Health Care ◽

Health Insurance ◽

Insurance Coverage ◽

Health Insurance Coverage ◽

Health Insurance System ◽

Major Health ◽

Insurance System ◽

Current Health ◽

Private And Public ◽

Care Costs

Lack of health insurance coverage is a large and growing problem for millions of American families. Rising health care costs and economic insecurity continue to threaten the bedrock of the health insurance system - employer-sponsored coverage - while states’ fiscal situations and the escalating federal deficit complicate any efforts at reform. Providing health insurance coverage to the millions of uninsured remains a major health care challenge for the nation and understanding the current health insurance environment, who the uninsured are, and why they are uninsured is critical when considering health care reform. This paper aims to define the problem of the uninsured, providing an overview of the uninsured in America and the roles and limits of private and public insurance. Following this discussion, the paper describes the current health insurance environment and examines the prospects for improving coverage.

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The Role of Health Insurance Coverage in Cancer Screening Utilization

Journal of Health Care for the Poor and Underserved ◽

10.1353/hpu.0.0048 ◽

2008 ◽

Vol 19 (3) ◽

pp. 842-856 ◽

Cited By ~ 33

Author(s):

JaMuir M. Robinson ◽

Vickie Shavers

Keyword(s):

Health Insurance ◽

Cancer Screening ◽

Insurance Coverage ◽

Health Insurance Coverage

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Racial/ethnic disparities in childhood cancer survival in the United States: Mediation effects of health insurance coverage and area-level social deprivation.

Journal of Clinical Oncology ◽

10.1200/jco.2019.37.27_suppl.143 ◽

2019 ◽

Vol 37 (27_suppl) ◽

pp. 143-143

Author(s):

Jingxuan Zhao ◽

Xuesong Han ◽

Zhiyuan Zheng ◽

Leticia Maciel Nogueira ◽

Paul C. Nathan ◽

...

Keyword(s):

United States ◽

Health Insurance ◽

Childhood Cancer ◽

Cancer Survival ◽

Social Deprivation ◽

Insurance Coverage ◽

Ethnic Disparities ◽

The United States ◽

Childhood Cancer Survival ◽

Racial Ethnic

143 Background: Childhood cancer survival varies by race/ethnicity in the United States. This study evaluated the impact of potentially modifiable characteristics - health insurance and area-level social deprivation - on racial/ethnic disparities in childhood cancer survival nationwide. Methods: We identified 65,113 childhood cancer patients aged < 18 years newly diagnosed with any of 10 common cancer types (e.g. central nervous system (CNS) neoplasms, acute lymphoblastic leukemia (ALL), Hodgkin lymphoma) from the 2004-2014 National Cancer Database. Cox proportional hazard models were used to compare survival probabilities by race and ethnicity (non-Hispanic white (NHW) vs non-Hispanic black (NHB), Hispanic, and non-Hispanic other (NH other)) for each cancer type. We conducted mediation analyses by the mma R package to evaluate the racial/ethnic survival disparities mediated by health insurance (private, Medicaid, and uninsured) and social deprivation index (SDI) quartile. SDI is a composite measure of deprivation based on seven characteristics (e.g. income, education, employment). Results: Compared to NHW, worse survival were observed for NHB (HR (hazard ratio): 1.4, 95% CI: 1.3-1.5), Hispanic (HR: 1.2, 95% CI: 1.1-1.2), and NH other (HR: 1.2, 95% CI: 1.1-1.3) for all cancer sites combined after adjusting for sociodemographic characteristics other than health insurance and SDI. Health insurance explained 20% of the survival disparities and SDI explained 19% of the disparity between NHB vs NHW; health insurance explained 48% of the survival disparities and SDI explained 45% of the disparity between Hispanic vs NHW. For ALL, health insurance significantly explained 15% and 18% of the survival disparities between NHB and Hispanic vs NHW, respectively. SDI significantly explained 19% and 31% of the disparities, respectively. Conclusions: Health insurance and SDI mediated racial/ethnic survival disparities for several childhood cancers. Expanding insurance coverage and improving healthcare access in disadvantaged areas may effectively reduce disparities for these cancer sites.

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