Enrolling Vulnerable, Uninsured but Eligible Children in Public Health Insurance: Association With Health Status and Primary Care Access

Primary care is the foundation of health care systems and has potential to alleviate inequities in population health. We examined multiple measures of adult primary care access, health status, and socioeconomic position at the New York City Council District level—a unit of analysis both relevant to and actionable by local policymakers. The results showed significant associations between measures of primary care access and health status after adjustment for socioeconomic factors. We found that an increase of 1 provider per 10 000 people was associated with a 1% decrease in diabetes rates and a 5% decrease in rates of adults without an influenza immunization. Furthermore, higher rates of primary care providers in high-poverty districts accepted Medicaid and had Patient-Centered Medical Home recognition, increasing constituent accessibility. Our findings highlight the significant contribution of primary care access to community health; policies and resource allocation must prioritize primary care facility siting and provider recruitment in low-access areas.

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The Impact of Children's Public Health Insurance Expansions on Educational Outcomes

Forum for Health Economics & Policy ◽

10.2202/1558-9544.1137 ◽

2009 ◽

Vol 12 (1) ◽

Cited By ~ 26

Author(s):

Phillip B Levine ◽

Diane Schanzenbach

Keyword(s):

Public Health ◽

Health Insurance ◽

Health Status ◽

Educational Outcomes ◽

Test Scores ◽

Children's Health ◽

Public Health Insurance ◽

Children’S Health ◽

Percentage Point Increase ◽

The Impact

This paper examines the impact of public health insurance expansions through both Medicaid and SCHIP on children's educational outcomes, measured by 4th and 8th grade reading and math test scores, available from the National Assessment of Educational Progress (NAEP). We use a triple difference estimation strategy, taking advantage of the cross-state variation over time and across ages in children's health insurance eligibility. Using this approach, we find that test scores in reading, but not math, increased for those children affected at birth by increased health insurance eligibility. A 50 percentage point increase in eligibility is found to increase reading test scores by 0.09 standard deviations. We also examine whether the improvements in educational outcomes can be at least partially attributed to improvements in health status itself. First, we provide further evidence that increases in eligibility are linked to improvements in health status at birth. Second, we show that better health status at birth (measured by rates of low birth-weight and infant mortality), is linked to improved educational outcomes. Although the methods used to support this last finding do not completely eliminate potentially confounding factors, we believe it is strongly suggestive that improving children's health will improve their classroom performance.

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Incentives to use primary care and their impact on healthcare utilization: Evidence using a public health insurance dataset in China

Social Science & Medicine ◽

10.1016/j.socscimed.2020.112981 ◽

2020 ◽

Vol 255 ◽

pp. 112981 ◽

Cited By ~ 1

Author(s):

Menghan Shen ◽

Wen He ◽

Linyan Li

Keyword(s):

Public Health ◽

Primary Care ◽

Health Insurance ◽

Healthcare Utilization ◽

Public Health Insurance

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The impact of chronic diseases and primary care access on health status among elderly populations in rural China

10.21203/rs.2.17171/v1 ◽

2019 ◽

Author(s):

Yixing Yang ◽

Tai zhang ◽

Zhaoquan Huang ◽

Dong Gao ◽

Zhenyou Guo ◽

...

Keyword(s):

Primary Care ◽

Health Status ◽

Rural Areas ◽

Chronic Conditions ◽

Rural China ◽

The Elderly ◽

Primary Care Access ◽

Care Access ◽

Descriptive System ◽

The Impact

Abstract Objective This study aimed to examine the patterns of chronic conditions and the role of primary care access on health status among rural elderly.Methods 6451 elderly aged ≥ 60 years from 5540 households in 116 villages in western rural areas of China were randomly selected and assessed the their health status using the EQ-5D-3L instrument. EQ-5D descriptive system and visual analogue scale (VAS) score were descriptive analyses by patterns of chronic conditions. We identified the impact of multimorbidity and primary care access on health status using multilevel linear model.Results 55% of the pooled sample reported at least one chronic condition, and 30.2% had more than one. Hypertension, rheumatoid arthritis and chronic bronchitis were the most frequently reported conditions. After adjustment for sociodemographic status and patterns of chronic conditions, primary care access significantly associated with health status for the elderly in late life.Conclusion Primary care access and health services should take priority action for rural elderly, especially elderly with multimobidity in lower household income, living in mountainous areas where distance to township hospital is long.

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