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- Title
Changes in health for the uninsured after reaching age-eligibility for Medicare.
- Authors
Baker, David W.; Feinglass, Joseph; Durazo-Arvizu, Ramon; Witt, Whitney P.; Sudano, Joseph J.; Thompson, Jason A.
- Abstract
<bold>Background: </bold>Uninsured adults in late middle age are more likely to have a health decline than individuals with private insurance.<bold>Objective: </bold>To determine how health and the risk of future adverse health outcomes changes after the uninsured gain Medicare.<bold>Design: </bold>Prospective cohort study.<bold>Participants: </bold>Participants (N=3,419) in the Health and Retirement Study who transitioned from private insurance or being uninsured to having Medicare coverage at the 1996, 1998, 2000, or 2002 interview.<bold>Measurements: </bold>We analyzed risk-adjusted changes in self-reported overall health and physical functioning during the transition period to Medicare (t(-2) to t(0)) and the following 2 years (t(0) to t(2)).<bold>Results: </bold>Between the interview before age 65 (t(-2)) and the first interview after reaching age 65 (t(0)), previously uninsured individuals were more likely than those who had private insurance to have a major decline in overall health (adjusted relative risk [ARR] 1.46; 95% confidence interval [CI] 1.03 to 2.04) and to develop a new physical difficulty affecting mobility (ARR 1.24; 95% CI 0.96 to 1.56) or agility (ARR 1.33; 95% CI 1.12 to 1.54). Rates of improvement were similar between the 2 groups. During the next 2 years (t(0) to t(2)), adjusted rates of declines in overall health and physical functioning were similar for individuals who were uninsured and those who had private insurance before gaining Medicare.<bold>Conclusions: </bold>Gaining Medicare does not lead to immediate health benefits for individuals who were uninsured before age 65. However, after 2 or more years of continuous coverage, the uninsured no longer have a higher risk of adverse health outcomes.
- Subjects
MEDICALLY uninsured persons; HEALTH; MEDICARE; HEALTH insurance; MEDICAL care for older people
- Publication
JGIM: Journal of General Internal Medicine, 2006, Vol 21, Issue 11, p1144
- ISSN
0884-8734
- Publication type
journal article
- DOI
10.1111/j.1525-1497.2006.00576.x