Effects of health insurance on patient demand for physician services
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RESEARCH
Open Access
Effects of health insurance on patient demand for physician services Jerome Dugan
Abstract Background: In recent years, policymakers have sought to reduce health disparities between the insured and uninsured through a federal health insurance expansion policy; however, disparities continue to persist among the insured population. One potential explanation is that the use of healthcare services varies by the type of health insurance coverage due to differences in the design of coverage. The aim of this study is to examine whether health insurance coverage type is associated with the structure and use of healthcare services. Methods: The nationally representative Medical Expenditure Panel Survey and multinomial logistic regression are used to estimate the effects of different types of health coverage on the combinations of routine and emergency care sought and received. Results: The multinomial logistic regression analysis for the overall sample revealed privately insured respondents reported higher use of routine care only (24.33%; p < 0.001) and lower use of emergency room care only (− 2.13%; p < 0.01) than the uninsured. The publicly insured reported similar trends for use of routine care only (17.93%; p < 0.001) as the privately insured, as compared to the uninsured. Both the privately and publicly insured reported higher use of a mixture of care; however, publicly insured were more likely to use a mixture of care (8.57%, p < 0.001). Conclusion: The results show that health insurance is associated with higher use of the physician services, but does not promote the use of cost-effective schedules of care among the publicly insured. Keywords: Healthcare management, Chronic disease, Health insurance
Introduction The Social Security Act Amendments (Pub L N. 89–97), passed in 1965, were designed to address the low rates of insurance among financially vulnerable households not receiving coverage from an employer by creating the Medicare insurance program for older adults over 65 and the Medicaid insurance program for low income mothers and children. However, in later years, coverage expansions have widened to include the remainder of the uninsured population using both a public and private mechanism. More specifically, the Affordable Care Act Correspondence: [email protected] Department of Health Services, School of Public Health, University of Washington, 1959 NE Pacific St Magnuson Health Sciences Center, Room H-680, Box 357660, Seattle, WA 98195-7660, USA
(Pub L N. 111–148) reduced the uninsured rate across the population by allowing states to expand Medicaid to include low-income adults, providing premium subsidies to help improve the affordability of private health plans, and imposing an individual mandate requiring all persons not receiving government or employer-based insurance to retain coverage. The most recent expansion policies under the ACA were able to lower the uninsured rate among non-elderly population from 46.5 million to 27.4 million between 2010 and 2017, thus highlighting the st
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