scholarly journals User–fee–removal improves equity of children’s health care utilization and reduces families’ financial burden: evidence from Jamaica

2017 ◽  
Vol 7 (1) ◽  
Author(s):  
Zhihui Li ◽  
Mingqiang Li ◽  
Günther Fink ◽  
Paul Bourne ◽  
Till Bärnighausen ◽  
...  
2012 ◽  
Vol 50 (3) ◽  
pp. 190-198 ◽  
Author(s):  
Susan Parish ◽  
Kathleen Thomas ◽  
Roderick Rose ◽  
Mona Kilany ◽  
Robert McConville

Abstract We examined the association between states' legislative mandates that private insurance cover autism services and the health care–related financial burden reported by families of children with autism. Child and family data were drawn from the National Survey of Children with Special Health Care Needs (N  =  2,082 children with autism). State policy characteristics were taken from public sources. The 3 outcomes were whether a family had any out-of-pocket health care expenditures during the past year for their child with autism, the expenditure amount, and expenditures as a proportion of family income. We modeled the association between states' autism service mandates and families' financial burden, adjusting for child-, family-, and state-level characteristics. Overall, 78% of families with a child with autism reported having any health care expenditures for their child for the prior 12 months. Among these families, 54% reported expenditures of more than $500, with 34% spending more than 3% of their income. Families living in states that enacted legislation mandating coverage of autism services were 28% less likely to report spending more than $500 for their children's health care costs, net of child and family characteristics. Families living in states that enacted parity legislation mandating coverage of autism services were 29% less likely to report spending more than $500 for their children's health care costs, net of child and family characteristics. This study offers preliminary evidence in support of advocates' arguments that requiring private insurers to cover autism services will reduce families' financial burdens associated with their children's health care expenses.


2016 ◽  
Vol 131 (2) ◽  
pp. 687-738 ◽  
Author(s):  
David Cesarini ◽  
Erik Lindqvist ◽  
Robert Östling ◽  
Björn Wallace

Abstract We use administrative data on Swedish lottery players to estimate the causal impact of substantial wealth shocks on players’ own health and their children’s health and developmental outcomes. Our estimation sample is large, virtually free of attrition, and allows us to control for the factors conditional on which the prizes were randomly assigned. In adults, we find no evidence that wealth impacts mortality or health care utilization, with the possible exception of a small reduction in the consumption of mental health drugs. Our estimates allow us to rule out effects on 10-year mortality one sixth as large as the cross-sectional wealth-mortality gradient. In our intergenerational analyses, we find that wealth increases children’s health care utilization in the years following the lottery and may also reduce obesity risk. The effects on most other child outcomes, including drug consumption, scholastic performance, and skills, can usually be bounded to a tight interval around zero. Overall, our findings suggest that in affluent countries with extensive social safety nets, causal effects of wealth are not a major source of the wealth-mortality gradients, nor of the observed relationships between child developmental outcomes and household income.


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