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- Title
Health Insurance and Poverty in Trajectories of Out-of-Pocket Expenditure among Low-Income Middle-Aged Adults.
- Authors
Kwon, Eunsun; Park, Sojung; McBride, Timothy D.
- Abstract
<bold>Objective: </bold>To assess the effects of longitudinal patterns of health insurance and poverty on out-of-pocket expenditures among low-income late middle-aged adults.<bold>Data Sources/study Setting: </bold>Six waves (2002-2012) of the Health and Retirement Study, in combination with RAND Center for the Study of Aging data, were used.<bold>Study Design: </bold>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.<bold>Principal Findings: </bold>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.<bold>Conclusions: </bold>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.
- Subjects
HEALTH insurance; MEDICAL care costs; HEALTH equity; POVERTY; PUBLIC health; INSURANCE; HEALTH insurance &; economics; INSURANCE statistics; HEALTH insurance statistics; COMPARATIVE studies; ECONOMICS; LONGITUDINAL method; RESEARCH methodology; MEDICAL cooperation; MEDICALLY uninsured persons; RESEARCH; RESEARCH funding; SURVEYS; EVALUATION research
- Publication
Health Services Research, 2018, Vol 53, Issue 6, p4332
- ISSN
0017-9124
- Publication type
journal article
- DOI
10.1111/1475-6773.12974