scholarly journals Risk-Adjusting the Doughnut Hole to Improve Efficiency and Equity

2011 ◽  
Vol 48 (4) ◽  
pp. 313-321 ◽  
Author(s):  
Richard C. van Kleef ◽  
Wynand P. M. M. van de Ven ◽  
Rene C. J. A. van Vliet
Keyword(s):  
Health Insurance ◽  
Health Status ◽  
Cost Containment ◽  
Cost Sharing ◽  
Important Goal ◽  
Medical Expenses ◽  
Improve Efficiency ◽  
Starting Point ◽  
Using Data

An important goal of consumer cost-sharing in health insurance is to increase incentives for cost containment. A relatively new cost-sharing phenomenon is the “doughnut hole”: a gap in coverage starting at a predefined level of medical expenses. An important question is where to locate the starting point to achieve the strongest incentives for cost containment. We argue that the answer depends on an individual's health status. Using data from a Dutch insurer, this paper illustrates that using a risk-adjusted starting point results in both stronger incentives for cost containment and more equity than a uniform starting point.

Health Insurance, Medical Care, and Children's Health

PEDIATRICS ◽  
1986 ◽  
Vol 77 (1) ◽  
pp. 124-128
Author(s):  
R. BURCIAGA VALDEZ ◽  
ARLEEN LEIBOWITZ ◽  
JOHN E. WARE ◽  
NAIHUA DUAN ◽  
GEORGE A. GOLDBERG ◽  
...  
Keyword(s):  
Health Insurance ◽  
Health Status ◽  
Medical Care ◽  
Cost Sharing ◽  
Medical Services ◽  
Randomized Experiment ◽  
Opportunity To Respond ◽  
Insurance Policies ◽  
Rand Health Insurance Experiment ◽  
Use Of Medical Services

We welcome this opportunity to respond to previously published commentaries by Drs Haggerty, Starfield, and Dutton on our discussions of how cost sharing affects the use of medical services and health status.1,2 Our purpose in responding is threefold: to reiterate succinctly the major conclusions of the Rand Health Insurance Experiment, to respond to issues raised by the commentators, and to emphasize certain points of agreement with them. Our goal is to promote a better understanding of the experiment and spur further discussion about the structure of health insurance for children. WHAT DID WE SHOW? In the Rand Health Insurance Experiment, a total of 1,844 children from six areas participated in a randomized experiment on the effects of cost sharing in health insurance policies.

scholarly journals Employment and Adverse Selection in Health Insurance

2014 ◽  
Vol 17 (1) ◽  
pp. 79-104
Author(s):  
Jayanta Bhattacharya ◽  
William B. Vogt
Keyword(s):  
Health Insurance ◽  
Health Status ◽  
Adverse Selection ◽  
Capital Requirements ◽  
Future Health ◽  
Department Of Labor ◽  
The Us ◽  
Pooling Equilibrium ◽  
Using Data ◽  
Specific Human Capital

Abstract We construct and test a new model of employer-provided health insurance provision in the presence of adverse selection in the health insurance market. In our model, employers cannot observe the health of their employees, but can decide whether to offer insurance. Employees sort themselves among employers who do and do not offer insurance on the basis of their current health status and the probability distribution over future health status changes. We show that there a pooling equilibrium is more likely when the costs of switching jobs are high or when health status is not persistent. We test and verify some of the key implications of our model using data from the Current Population Survey, linked to information provided by the US Department of Labor about the job-specific human capital requirements of jobs.

Comparison of Examinees’ and Doctors’ Judgement of Health Status Using Data in an AMHTS

1984 ◽  
Vol 23 (01) ◽  
pp. 15-22
Author(s):  
Y. Sekita ◽  
T. Ohta ◽  
M. Inoue ◽  
H. Takeda
Keyword(s):  
Health Status ◽  
Discriminant Analysis ◽  
Explanatory Power ◽  
Laboratory Data ◽  
Subjective Symptom ◽  
Health Conditions ◽  
Testing System ◽  
Multiple Discriminant Analysis ◽  
Canonical Axis ◽  
Using Data

SummaryJudgements of examinees’ health status by doctors and by the examinees themselves are compared applying multiple discriminant analysis. The doctors’ judgements of the examinees’ health status are studied comparatively using laboratory data and the examinees’ subjective symptom data.This data was obtained in an Automated Multiphasic Health Testing System. We discuss the health conditions which are significant for the judgement of doctors about the examinees. The results show that the explanatory power, when using subjective symptom data, is fair in the case of the doctors’ judgement. We found common variables, such as nervousness, lack of perseverance etc., which form the first canonical axis.

Oral Health Status and Oral Health Services Utilization of Myanmar Residents in Japan

2019 ◽  
Vol 31 (1) ◽  
pp. 81-86
Keyword(s):  
Health Insurance ◽  
Health Status ◽  
Oral Health ◽  
Periodontal Disease ◽  
Health Care Services ◽  
Health Knowledge ◽  
Oral Health Status ◽  
Services Utilization ◽  
Periodontal Index ◽  
The Status

The purpose of this study was to investigate oral health status and oral health care services utilization among Myanmar residents in Japan. A crosssectional epidemiological study was performed among 152 Myanmar residents aged 18 to 67 years in Tokyo, Japan. Clinical oral examinations and questionnaire surveys were conducted from June to July, 2017. Caries prevalence for all participants was 70.4% with mean decayed, missing, and filled teeth (DMFT) of 2.72±2.91. The prevalence of periodontal disease (Community Periodontal Index - CPI code 1) for all participants was 93.4%. A total of 67 participants (44.1%) had the experience of dental visits in Japan. Most participants (84.2%) had Japanese health insurance, and the participants with health insurance had a significantly higher number of filled teeth than those without (p=0.036). DMFT (p=0.020) and the prevalence of periodontal disease (p=0.049) were significantly lower in participants with health insurance than in those without. Further, self-perceived oral health was better in participants with health insurance than those without (p=0.001). The status of health insurance was indicated to influence on oral health status. In order to promote oral health and facilitate on owning health insurance to Myanmar residents in Japan, oral health education also should be provided to enhance their oral health knowledge.

scholarly journals Temporal trends and variation in out-of-pocket expenditures and patient cost sharing: evidence from a Chinese national survey 2011–2015

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Vicky Mengqi Qin ◽  
Yuting Zhang ◽  
Kee Seng Chia ◽  
Barbara McPake ◽  
Yang Zhao ◽  
...  
Keyword(s):  
Prescription Drugs ◽  
Cost Sharing ◽  
Temporal Trends ◽  
Absolute Amount ◽  
Financial Protection ◽  
Patient Cost ◽  
Older Chinese ◽  
Using Data ◽  
Reported Data ◽  
The Relationship

Abstract Objectives This study aims to examine: (1) temporal trends in the percentage of cost-sharing and amount of out-of-pocket expenditure (OOPE) from 2011 to 2015; (2) factors associated with cost-sharing and OOPE; and (3) the relationships between province-level economic development and cost-sharing and OOPE in China. Setting A total of 10,316 adults aged ≥45 years from China followed-up from 2011 to 2015 were included in the analysis. We measured two main outcome variables: (1) patient cost sharing, measured by the percentage of OOPE as total healthcare expenditure, and (2) absolute amount of OOPE. Results Based on self-reported data, we did not find substantial differences in the percentage of cost sharing, but a significant increase in the absolute amount of OOPE among the middle-aged and older Chinese between 2011 and 2015. The percentage of cost-sharing was considerably higher for outpatient than inpatient care, and the majority paid more than 80% of the total cost for prescription drugs. Provinces with higher GDP per capita tend to have lower cost-sharing and a higher OOPE than their counterparts, but the relationship for OOPE became insignificant after adjusting for individual factors. Conclusion Reducing out-of-pocket expenditure and patient cost sharing is required to improve financial protection from illness, especially for those with those with chronic conditions and reside in less developed regions in China. Ongoing monitoring of financial protection using data from various sources is warranted.

scholarly journals Self-Rated Health Status Based on the Type of Health Insurance: A Socioeconomic Perspective

2021 ◽  
Vol 58 ◽  
pp. 004695802110281
Author(s):  
Minsung Sohn ◽  
Minsoo Jung ◽  
Mankyu Choi
Keyword(s):  
Socioeconomic Status ◽  
Health Insurance ◽  
Health Status ◽  
Regression Models ◽  
Private Health Insurance ◽  
Public And Private ◽  
Logistic Regression Models ◽  
Self Rated Health ◽  
Interaction Terms ◽  
Healthcare Coverage

To investigate the effects of public and private health insurance on self-rated health (SRH) status within the National Health Insurance (NHI) system based on socioeconomic status in South Korea. The data were obtained from 10 867 respondents of the Korea Health Panel (2008-2011). We used hierarchical panel logistic regression models to assess the SRH status. We also added the interaction terms of socioeconomic status and type of health insurance as moderators. Medical aid (MA) recipients were 2.10 times more likely to have a low SRH status than those who were covered only by the NHI, even though the healthcare utilization was higher. When the interaction terms were included, those not covered by the NHI and had completed elementary school or less were 16.59 times more likely to have a low SRH status than those covered by the NHI and had earned a college degree or higher. Expanding healthcare coverage to reduce the burden of non-payment and unmet use to improve the health status of MA beneficiaries should be considered. Particularly, the vulnerability of less-educated groups should be focused on.

scholarly journals Humidifier Disinfectant Consumption and Humidifier Disinfectant-Associated Lung Injury in South Korea: A Nationwide Population-Based Study

2021 ◽  
Vol 18 (11) ◽  
pp. 6136
Author(s):  
Jeonggyo Yoon ◽  
Minsun Kang ◽  
Jaehun Jung ◽  
Min Jae Ju ◽  
Sung Hwan Jeong ◽  
...  
Keyword(s):  
Health Insurance ◽  
Lung Injury ◽  
National Health Insurance ◽  
Population Based ◽  
Annual Number ◽  
Population Based Study ◽  
Annual Consumption ◽  
Using Data ◽  
Water Tanks ◽  
Biocidal Product

Humidifier disinfectant (HD) is a household biocidal product used in humidifier water tanks to prevent the growth of microorganisms. In 2011, a series of lung injury cases of unknown causes emerged in children and pregnant women who had used HD in Korea. This study investigated changes in the nationwide number of cases of humidifier disinfectant-associated lung injury (HDLI) in concordance with nationwide HD consumption using data covering the entire Korean population. More than 25 kinds of HD products were sold between 1994 and 2011. The number of diagnosed HDLI, assessed by S27.3 (other injuries of lungs) of the Korea National Health Insurance Service (NHIS) data, sharply increased by 2005, subsequently decreased after 2005, and almost disappeared after 2011 in concordance with the annual number of HD sales. The number of self-reported HDLIs, assessed using data from all suspected HDLI cases registered in the Korea Ministry of Environment, changed with the annual number of HD sales, with a delay pattern, potentially induced by the late awareness of lung injury diseases. The present study suggests that changes in the nationwide annual consumption of HD products were consistent with changes in the annual number of HDLI cases in Korea.

Health Insurance and Health Status: Exploring the Causal Effect from a Policy Intervention

2015 ◽  
Vol 25 (11) ◽  
pp. 1389-1402 ◽  
Author(s):  
Jay Pan ◽  
Xiaoyan Lei ◽  
Gordon G. Liu
Keyword(s):  
Health Insurance ◽  
Health Status ◽  
Causal Effect ◽  
Policy Intervention
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