Health Insurance and Poverty in Trajectories of Out‐of‐Pocket Expenditure among Low‐Income Middle‐Aged Adults

Autor:	Eunsun Kwon, Sojung Park, Timothy D. McBride
Rok vydání:	2018
Předmět:	Male Financing Personal Social Determinants of Health Population Insurance Coverage Odds 03 medical and health sciences 0302 clinical medicine Humans Longitudinal Studies 030212 general & internal medicine education Baseline (configuration management) Poverty Socioeconomic status Medically Uninsured education.field_of_study Insurance Health 030503 health policy & services Health Policy Multilevel model Regression analysis Middle Aged Health and Retirement Study Health Surveys Female Demographic economics Business Health Expenditures 0305 other medical science
Zdroj:	Health Services Research. 53:4332-4352
ISSN:	1475-6773 0017-9124
DOI:	10.1111/1475-6773.12974
Popis:	Objective To assess the effects of longitudinal patterns of health insurance and poverty on out-of-pocket expenditures among low-income late middle-aged adults. Data sources/study setting Six waves (2002-2012) of the Health and Retirement Study, in combination with RAND Center for the Study of Aging data, were used. Study design A random coefficient regression analysis was conducted in a multilevel growth curve framework to estimate the impact of health insurance and poverty on out-of-pocket expenditures. Principal findings At baseline, individuals with private insurance or unstable coverage were more likely to have out-of-pocket expenditures and financial burdens than public insurance holders. Over time, the poor who had no insurance, unstable coverage, or insurance type change had higher out-of-pocket expenditures; private coverage holders had higher odds of financial burden. Conclusions Unstable insurance coverage had a discernible effect on the long-term, out-of-pocket expenditures among low-income adults. Findings have an important policy implication to protect poor late middle-aged population; as this population enters old age, the high financial burden it faces may exacerbate persistent socioeconomic health disparity among older people with unstable insurance coverage.
Databáze:	OpenAIRE
Externí odkaz:	https://explore.openaire.eu/search/publication?articleId=doi_dedup___::cd6e842ec1e15d7c82256870d9263729 https://doi.org/10.1111/1475-6773.12974 Zobrazit plný text záznamu Plný text ve formátu PDF Plný text ve formátu HTML
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