Effect of Child Health Insurance Plan Enrollment on the Utilization of Health Care Services by Children Using a Public Safety Net System

PEDIATRICS ◽  
2002 ◽  
Vol 110 (5) ◽  
pp. 940-945 ◽  
Author(s):  
S. Eisert ◽  
P. Gabow
2004 ◽  
Vol 4 (2) ◽  
pp. 154-161 ◽  
Author(s):  
Allison Kempe ◽  
Brenda L. Beaty ◽  
Lori A. Crane ◽  
Jennifer Barrow ◽  
Johan Stokstad ◽  
...  

PEDIATRICS ◽  
2003 ◽  
Vol 111 (4) ◽  
pp. 735-740 ◽  
Author(s):  
A. Kempe ◽  
B. Renfrew ◽  
J. Barrow ◽  
D. Cherry ◽  
A. Levinson ◽  
...  

Risks ◽  
2020 ◽  
Vol 8 (2) ◽  
pp. 41
Author(s):  
Veronika Kalouguina ◽  
Joël Wagner

In compulsory health insurance in Switzerland, policyholders can choose two main features, the level of deductible and the type of plan. Deductibles can be chosen among six levels, which range from CHF 300 to 2500. While the coverage and benefits are identical, insurers offer several plans where policyholders must first call a medical hotline, consult their family doctor, or visit a doctor from a defined network. The main benefit of higher deductibles and insurance plans with limitations is lower premiums. The insureds’ decisions to opt for a specific cover depend on observed and unobserved characteristics. The aim of this research is to understand the correlation between insurance plan choices and lifestyle through the state of health and medical care consumption in the setting of Swiss mandatory health insurance. To do so, we account for individual health and medical health care consumption as unobserved variables employing structural equation modeling. Our empirical analysis is based on data from the Swiss Health Survey wherein lifestyle factors like the body mass index, diet, physical activity, and commuting mode are available. From the 9301 recorded observations, we find a positive relationship between having a “healthy” lifestyle, a low consumption of doctors’ services, and choosing a high deductible, as well as an insurance plan with restrictions. Conversely, higher health care services’ usage triggers the choice of lower deductibles and standard insurance plans.


2014 ◽  
Author(s):  
Susana J. Ferradas ◽  
G. Nicole Rider ◽  
Johanna D. Williams ◽  
Brittany J. Dancy ◽  
Lauren R. Mcghee

Author(s):  
Laura Nedzinskienė ◽  
Elena Jurevičienė ◽  
Žydrūnė Visockienė ◽  
Agnė Ulytė ◽  
Roma Puronaitė ◽  
...  

Background. Patients with multimorbidity account for ever-increasing healthcare resource usage and are often summarised as big spenders. Comprehensive analysis of health care resource usage in different age groups in patients with at least two non-communicable diseases is still scarce, limiting the quality of health care management decisions, which are often backed by limited, small-scale database analysis. The health care system in Lithuania is based on mandatory social health insurance and is covered by the National Health Insurance Fund. Based on a national Health Insurance database. The study aimed to explore the distribution, change, and interrelationships of health care costs across the age groups of patients with multimorbidity, suggesting different priorities at different age groups. Method. The study identified all adults with at least one chronic disease when any health care services were used over a three-year period between 2012 and 2014. Further data analysis excluded patients with single chronic conditions and further analysed patients with multimorbidity, accounting for increasing resource usage. The costs of primary, outpatient health care services; hospitalizations; reimbursed and paid out-of-pocket medications were analysed in eight age groups starting at 18 and up to 85 years and over. Results. The study identified a total of 428,430 adults in Lithuania with at least two different chronic diseases from the 32 chronic disease list. Out of the total expenditure within the group, 51.54% of the expenses were consumed for inpatient treatment, 30.90% for reimbursed medications. Across different age groups of patients with multimorbidity in Lithuania, 60% of the total cost is attributed to the age group of 65–84 years. The share in the total spending was the highest in the 75–84 years age group amounting to 29.53% of the overall expenditure, with an increase in hospitalization and a decrease in outpatient services. A decrease in health care expenses per capita in patients with multimorbidity after 85 years of age was observed. Conclusions. The highest proportion of health care expenses in patients with multimorbidity relates to hospitalization and reimbursed medications, increasing with age, but varies through different services. The study identifies the need to personalise the care of patients with multimorbidity in the primary-outpatient setting, aiming to reduce hospitalizations with proactive disease management.


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