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The increasing availability of dental insurance for children, and the relationship between insurance and dental visits are detailed. In the changing environment for the delivery of dental services, successful dental practice and general medical practice increasingly require that health providers recognize the variations in the new populations served.
This paper uses data on health spending and health status from the Medical Expenditure Panel Survey (MEPS) to estimate the differences in health spending across different types of insurance and across incomes that are attributable solely to health status differences. The results show that the uninsured are less costly than those on Medicaid, based on health status alone, but are more costly than those with employer-sponsored insurance. Adults and children with private nongroup coverage are also less expensive than average, because of better-than-average health. Finally, the data show that expenditures fall (health status improves) with income, regardless of type of coverage.
It was anticipated that the recent reforms to private health insurance arrangements would reduce the demand pressures on Australian public hospitals. However, this has not been demonstrated by trends in elective surgery waiting lists in Victorian public hospitals. Moreover, it appears that the increased caseload assumed by Victorian private hospitals since the reforms took effect mainly reflects an increase in low cost same day episodes.
UNLABELLED: In nursing insurance according to German legislation, the act of classifying the client into degrees of severity of disablement (0 = none, 1 to 3 = considerable, severe, most severe disablement) by expert assessment is based on legally defined distinct criteria (need for help items). Over and above these criteria, information with regard to the activities of daily life (ADL) is also documented routinely. PURPOSE: Is there a fundamental difference between patients suitable for ambulatory or non-ambulatory nursing care, or are their positive pattern scores for needing help fundamentally different? METHODS: Based on 7,000 electronic records of the assessments for ambulatory, and another 7,000 records for non-ambulatory nursing care, we fed artificial neural networks with all, or subsets, of the available items. Thereafter, in a crossover design, we evaluated the nets' classification competencies on independent validation data, using the ambulatory net for non-ambulatory classification, and vice versa. Weighted kappa (kw) was calculated as an index of performance. RESULTS: The nets trained on ambulatory data uniformly performed slightly better on ambulatory than on non-ambulatory data (kw = 0.78 versus 0.65, all items; 0.68 versus 0.67, only ADL items), whereas the non-ambulatory nets showed no consistent difference in respect of the nature of the input data (kw = 0.76/0.77, and 0.71/0.66). Overall, the nets' classification competence was convincing. CONCLUSION: There are inter-group differences regarding the need for care. The more severely disabled clients are mainly in the non-ambulatory group. But the principles governing the need for care are very similar in both groups. Thus, a uniform assessment procedure with regard to individual patient disability is justified. From the viewpoint of quality control, the results are reassuring.
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Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
In this article, we examine the health insurance status of working-age, physically disabled persons, and particularly the question of whether the public sector insures a disproportionate share of the highest-risk disabled population. We use descriptive statistics to develop an insurance profile of respondents with severe physical disabilities, and multivariate procedures to model differences between privately and publicly insured, disabled persons. Results of logistic regression procedures indicate that respondents with private insurance alone are more likely to have a high functional level, a positive perception of their health, and to be married, than are those with public (or a combination of public and private) insurance. Specific type of disability, age, and wheelchair use were also found to predict the type of insurance, their effects largely mediated by employment status and income.
The authors of this article have used Current Population Surveys to summarize public and private health insurance trends in the United States over the last 12 years. Key findings include the declining percentage of the non-elderly population with employer-sponsored coverage and increasing numbers of low- and middle-income uninsured. That is, in a period of fast-rising health care costs, the poor and the near-poor in working families have been losing coverage for health care and facing increasing risks of inadequate care and financial loss. These data highlight health care access and financing problems now facing the Nation.
Efforts to extend coverage to pregnant women, along with an expanding economy, did not prevent increases in the uninsured in the latter 1990s. Welfare reform may have led to declining Medicaid enrollments and caseloads. Data representative of live births in nine states show that in some states more than one-third of all pregnant women and almost two-thirds of low-income pregnant women lacked insurance before their pregnancy in 1996 and 1999. More than one-third of all pregnant women made some change in coverage by the time they delivered their baby. Among low-income women, the largest change was from uninsured status before pregnancy to Medicaid at delivery.
When insurance benefits for outpatient psychotherapy are expanded to cover alternative (less expensive) types of providers, lower reimbursements from beneficiaries' use of these providers may offset reimbursement increases attributable to any concomitant increase in demand for services. In this paper, outpatient claims data from Massachusetts Blue Shield for 1979-83 are used to estimate demand and substitution effects of a state mandate of direct reimbursement to social workers, starting April 1, 1982. Empirical results for the first year of the mandate showed that while the percentage of beneficiaries using the benefit did not change from 1981, eligible social workers in the state treated 10% of "new" users of the outpatient benefit and 2% of "continuing" users. While the substitution effect predominated, the particular characteristics of the Massachusetts case limit more general applicability of the results.
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