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Essays on the economic burden of diabetes and the effect of SCHIP expansion on insurance coverage in Hawai`i.

机译:关于糖尿病的经济负担以及SCHIP扩展对夏威夷州保险覆盖范围的影响的论文。

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摘要

Chapter 1 uses the 2004 to 2008 Medical Expenditure Panel Survey to estimate the difference in annual medical expenditures between diabetics and non-diabetics. Various propensity score matching methods demonstrate that an adult diagnosed with diabetes incurs annual expenditures ;Chapter 2 analyzes the diabetes expenditure differential over progression of the disease. Using propensity score matching, diabetes progression is defined both by disease duration and severity, as measured by treatment regimen. A persistent, statistically significant increase in the expenditure differential is estimated over diabetes duration quartile, with prescription drug, hospital and office-based provider expenditures of diabetics all increasing relative to those of non-diabetics. While diabetics treated with insulin incur the highest expenditures relative to non-diabetics, those treated with a diet modification alone are estimated to incur higher expenditures relative to non-diabetics than diabetics on a regimen of oral medication.;Chapter 3 evaluates the effect of State Children's Health Insurance Program (SCHIP) expansion on insurance coverage in Hawaii using the 1998 to 2008 Current Population Survey. A model-based difference-in-differences approach compares changes in insurance coverage between the group of SCHIP-targeted children and a control group consisting of children for whom eligibility remained constant over the period of analysis. We estimate a 20 percent take-up rate of SCHIP and an 87 percent crowd-out rate of private insurance among newly-eligible children.
机译:第1章使用2004年至2008年医疗支出小组调查来估计糖尿病患者和非糖尿病患者之间年度医疗支出的差异。各种倾向评分匹配方法表明,被诊断患有糖尿病的成年人每年会产生支出;第二章分析了糖尿病在疾病发展过程中的支出差异。使用倾向评分匹配,通过疾病持续时间和严重程度来定义糖尿病的进展,通过治疗方案来衡量。据估计,在糖尿病持续时间的四分位数中,支出差异的持续的,统计上的显着增加,与非糖尿病患者相比,糖尿病患者的处方药,医院和办公室提供者的支出都在增加。虽然用胰岛素治疗的糖尿病患者相对于非糖尿病患者的支出最高,但据估计,仅通过饮食改良治疗的糖尿病患者相对于非糖尿病患者,口服药物治疗方案的支出要高于糖尿病患者;;第3章评估了国家对糖尿病的影响儿童健康保险计划(SCHIP)使用1998年至2008年的当前人口调查扩大了夏威夷的保险范围。基于模型的差异方法比较了以SCHIP为目标的儿童组与由合格率在分析期间保持不变的儿童组成的对照组之间的保险覆盖范围变化。我们估计,新入学的儿童中SCHIP的使用率达到20%,私人保险的挤出率达到87%。

著录项

  • 作者

    Lindo, Jaclyn-Rashel Keiko.;

  • 作者单位

    University of Hawai'i at Manoa.;

  • 授予单位 University of Hawai'i at Manoa.;
  • 学科 Economics General.;Health Sciences Health Care Management.;Health Sciences Public Health.
  • 学位 Ph.D.
  • 年度 2011
  • 页码 235 p.
  • 总页数 235
  • 原文格式 PDF
  • 正文语种 eng
  • 中图分类
  • 关键词

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