Thomas Buchmueller, John C. Ham, and Lara D. Shore-Sheppard
- Published in print:
- 2016
- Published Online:
- May 2017
- ISBN:
- 9780226370477
- eISBN:
- 9780226370507
- Item type:
- chapter
- Publisher:
- University of Chicago Press
- DOI:
- 10.7208/chicago/9780226370507.003.0002
- Subject:
- Economics and Finance, Public and Welfare
In both its costs and the number of its enrollees, Medicaid is the largest means-tested transfer program in the United States. It is also a fundamental part of the health care system, providing ...
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In both its costs and the number of its enrollees, Medicaid is the largest means-tested transfer program in the United States. It is also a fundamental part of the health care system, providing health insurance to low-income families, indigent seniors, disabled adults and, in some states, low-income adults more broadly. This paper reviews the history and structure of the Medicaid program and the large body of economic research that it has spawned in the nearly half century since it was established. We begin by summarizing the program’s history, goals and current rules. We then present program statistics, mainly related to enrollment and expenditures. Finally we turn to the research on the impact of Medicaid on a broad range of outcomes, discussing theoretical and methodological issues important for understanding these effects and reviewing the empirical literature, describing what has been learned thus far, investigating areas where studies seem to reach different conclusions and pointing to areas where we believe additional research would be fruitful.Less
In both its costs and the number of its enrollees, Medicaid is the largest means-tested transfer program in the United States. It is also a fundamental part of the health care system, providing health insurance to low-income families, indigent seniors, disabled adults and, in some states, low-income adults more broadly. This paper reviews the history and structure of the Medicaid program and the large body of economic research that it has spawned in the nearly half century since it was established. We begin by summarizing the program’s history, goals and current rules. We then present program statistics, mainly related to enrollment and expenditures. Finally we turn to the research on the impact of Medicaid on a broad range of outcomes, discussing theoretical and methodological issues important for understanding these effects and reviewing the empirical literature, describing what has been learned thus far, investigating areas where studies seem to reach different conclusions and pointing to areas where we believe additional research would be fruitful.
Joseph E. Ravenell
- Published in print:
- 2010
- Published Online:
- September 2010
- ISBN:
- 9780195314366
- eISBN:
- 9780199865567
- Item type:
- chapter
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:oso/9780195314366.003.0011
- Subject:
- Social Work, Communities and Organizations, Health and Mental Health
Young and middle-aged African American men (15-45 years old) are disproportionately affected by accidental injury, human immunodeficiency virus (HIV), and cardiovascular disease. These conditions are ...
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Young and middle-aged African American men (15-45 years old) are disproportionately affected by accidental injury, human immunodeficiency virus (HIV), and cardiovascular disease. These conditions are preventable and are amenable to primary care intervention, yet African American men underutilize primary care health services. Because health-care utilization is strongly dependent on health beliefs among other factors, this chapter identifies and explores African American men's perceptions of health and health influences. It analyzes focus group interviews with select subgroups of African American men, including adolescents, trauma survivors, and HIV-positive men. Their definitions of health and beliefs about influences on health are elicited. The chapter provides insight into African American males' general health perceptions, and may have implications for future efforts to improve healthcare utilization and health in this population. Recommendations for future directions to improve African American males' health are explored.Less
Young and middle-aged African American men (15-45 years old) are disproportionately affected by accidental injury, human immunodeficiency virus (HIV), and cardiovascular disease. These conditions are preventable and are amenable to primary care intervention, yet African American men underutilize primary care health services. Because health-care utilization is strongly dependent on health beliefs among other factors, this chapter identifies and explores African American men's perceptions of health and health influences. It analyzes focus group interviews with select subgroups of African American men, including adolescents, trauma survivors, and HIV-positive men. Their definitions of health and beliefs about influences on health are elicited. The chapter provides insight into African American males' general health perceptions, and may have implications for future efforts to improve healthcare utilization and health in this population. Recommendations for future directions to improve African American males' health are explored.
Jonathan Gruber
- Published in print:
- 2003
- Published Online:
- February 2013
- ISBN:
- 9780226533568
- eISBN:
- 9780226533575
- Item type:
- chapter
- Publisher:
- University of Chicago Press
- DOI:
- 10.7208/chicago/9780226533575.003.0002
- Subject:
- Economics and Finance, Public and Welfare
This chapter reviews the structure of the Medicaid program and its economic impact. Section 1.1 begins by reviewing the program's history, and discussing the evolution and current structure of ...
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This chapter reviews the structure of the Medicaid program and its economic impact. Section 1.1 begins by reviewing the program's history, and discussing the evolution and current structure of program rules. Section 1.2 then turns to a more detailed discussion of the program as it currently exists, presenting a variety of statistics on enrollment and expenditures. Section 1.3 provides a heuristic overview of the economic impacts of the Medicaid program, and Section 1.4 reviews the large empirical literature on the Medicaid program and its impacts on health care utilization, health, labor supply, family structure, and other behaviors. Section 1.5 discusses current policy issues and how they are informed (or not informed) by the existing literature, and Section 1.6 concludes.Less
This chapter reviews the structure of the Medicaid program and its economic impact. Section 1.1 begins by reviewing the program's history, and discussing the evolution and current structure of program rules. Section 1.2 then turns to a more detailed discussion of the program as it currently exists, presenting a variety of statistics on enrollment and expenditures. Section 1.3 provides a heuristic overview of the economic impacts of the Medicaid program, and Section 1.4 reviews the large empirical literature on the Medicaid program and its impacts on health care utilization, health, labor supply, family structure, and other behaviors. Section 1.5 discusses current policy issues and how they are informed (or not informed) by the existing literature, and Section 1.6 concludes.
Thomas D. Koepsell and Noel S. Weiss
- Published in print:
- 2004
- Published Online:
- September 2009
- ISBN:
- 9780195150780
- eISBN:
- 9780199865161
- Item type:
- chapter
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:oso/9780195150780.003.0006
- Subject:
- Public Health and Epidemiology, Public Health, Epidemiology
Epidemiologists are often data scavengers. Using pre-existing data can allow a study to be done more cheaply, more quickly, and often on a larger scale than if new data collection were required. This ...
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Epidemiologists are often data scavengers. Using pre-existing data can allow a study to be done more cheaply, more quickly, and often on a larger scale than if new data collection were required. This chapter considers the strengths and weaknesses of several commonly used kinds of pre-existing data, as well as some techniques for assessing and dealing with data limitations. It focuses mainly on data resources available in the United States. Topics covered include numerator data, health care utilization data, and denominator data. Exercises are provided at the end of the chapter.Less
Epidemiologists are often data scavengers. Using pre-existing data can allow a study to be done more cheaply, more quickly, and often on a larger scale than if new data collection were required. This chapter considers the strengths and weaknesses of several commonly used kinds of pre-existing data, as well as some techniques for assessing and dealing with data limitations. It focuses mainly on data resources available in the United States. Topics covered include numerator data, health care utilization data, and denominator data. Exercises are provided at the end of the chapter.
Thomas Macurdy and Jeff Geppert (eds)
- Published in print:
- 2005
- Published Online:
- February 2013
- ISBN:
- 9780226902869
- eISBN:
- 9780226903217
- Item type:
- chapter
- Publisher:
- University of Chicago Press
- DOI:
- 10.7208/chicago/9780226903217.003.0004
- Subject:
- Economics and Finance, Econometrics
This chapter explores patterns of expenses for high-cost users of Medicare. It aims to develop a transparent approach for identifying these beneficiaries and determining the concentration of their ...
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This chapter explores patterns of expenses for high-cost users of Medicare. It aims to develop a transparent approach for identifying these beneficiaries and determining the concentration of their health care utilization. The analysis reveals that that 20–30 percent of the total growth in Medicare program payments from 1989 to 1999 came from an increase in the participation rate while 50–60 percent was from an increase in average program payments per service recipient.Less
This chapter explores patterns of expenses for high-cost users of Medicare. It aims to develop a transparent approach for identifying these beneficiaries and determining the concentration of their health care utilization. The analysis reveals that that 20–30 percent of the total growth in Medicare program payments from 1989 to 1999 came from an increase in the participation rate while 50–60 percent was from an increase in average program payments per service recipient.
Lamia P. Barakat and Rhonda C. Boyd
- Published in print:
- 2006
- Published Online:
- November 2020
- ISBN:
- 9780195169850
- eISBN:
- 9780197562192
- Item type:
- chapter
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/oso/9780195169850.003.0035
- Subject:
- Clinical Medicine and Allied Health, Clinical Oncology
Because sickle cell disease (SCD) largely affects individuals of African descent, throughout this chapter the importance of a culturally sensitive and competent family systems approach to ...
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Because sickle cell disease (SCD) largely affects individuals of African descent, throughout this chapter the importance of a culturally sensitive and competent family systems approach to understanding family issues in SCD is advocated. After African American families are described in some depth, including their strengths, unique features, and special concerns, frameworks for understanding how SCD may have an impact on family functioning are presented with emphasis on the developmental-ecological model of family functioning (Kazak, 1989). This model is used to characterize family systems issues associated with SCD, and specific elements are examined. Developmental changes in family adaptation over the course of the illness are considered, as are efforts to intervene in family adaptation. Broad sociocultural systems issues with an impact on families of African descent are described, and the need for culturally sensitive and respectful approaches to families affected by SCD is underscored. Finally, unexamined areas in family systems issues for pediatric SCD are considered, with suggestions for further research. Understanding family systems issues in pediatric SCD is critical to providing effective care and to facilitating optimal adaptation in the context of the disease and its treatment. A discussion of family issues pertinent to SCD must start by acknowledging that sociocultural factors, including race, ethnicity, and culture, are central because African Americans are the primary group diagnosed with SCD in the United States, and that family functioning is impacted by SCD and its treatment demands almost immediately following the birth of a child. There are a host of sociocultural factors that have an impact on African Americans that may increase resilience or risk to overall family adaptation to a child’s disease. Therefore, it is imperative to understand families of children with SCD in the context of the immediate conditions in which they live and the larger sociopolitical context in which they function (Johnson et al., 1995; Sterling, Peterson, & Weekes, 1997).
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Because sickle cell disease (SCD) largely affects individuals of African descent, throughout this chapter the importance of a culturally sensitive and competent family systems approach to understanding family issues in SCD is advocated. After African American families are described in some depth, including their strengths, unique features, and special concerns, frameworks for understanding how SCD may have an impact on family functioning are presented with emphasis on the developmental-ecological model of family functioning (Kazak, 1989). This model is used to characterize family systems issues associated with SCD, and specific elements are examined. Developmental changes in family adaptation over the course of the illness are considered, as are efforts to intervene in family adaptation. Broad sociocultural systems issues with an impact on families of African descent are described, and the need for culturally sensitive and respectful approaches to families affected by SCD is underscored. Finally, unexamined areas in family systems issues for pediatric SCD are considered, with suggestions for further research. Understanding family systems issues in pediatric SCD is critical to providing effective care and to facilitating optimal adaptation in the context of the disease and its treatment. A discussion of family issues pertinent to SCD must start by acknowledging that sociocultural factors, including race, ethnicity, and culture, are central because African Americans are the primary group diagnosed with SCD in the United States, and that family functioning is impacted by SCD and its treatment demands almost immediately following the birth of a child. There are a host of sociocultural factors that have an impact on African Americans that may increase resilience or risk to overall family adaptation to a child’s disease. Therefore, it is imperative to understand families of children with SCD in the context of the immediate conditions in which they live and the larger sociopolitical context in which they function (Johnson et al., 1995; Sterling, Peterson, & Weekes, 1997).
David Daley, Rasmus Højbjerg Jacobsen, Anne‐Mette Lange, Anders Sørensen, and Jeanette Walldorf
- Published in print:
- 2015
- Published Online:
- September 2015
- ISBN:
- 9780198745556
- eISBN:
- 9780191807619
- Item type:
- chapter
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:oso/9780198745556.003.0005
- Subject:
- Economics and Finance, Public and Welfare
The chapter presents descriptive statistics about two patient groups. The areas shown are: family background, labour-market attainment, criminal history, traffic accidents, childhood outcomes, family ...
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The chapter presents descriptive statistics about two patient groups. The areas shown are: family background, labour-market attainment, criminal history, traffic accidents, childhood outcomes, family situation, and general health care. The statistics show that (i) parents of individuals with ADHD are younger and earn less than parents of the average person in the rest of the population; (ii) individuals who have ADHD on average have less education, are more likely to be out of the labour force, and earn significantly less than members of the general population; (iii) persons with ADHD are more likely to engage in criminal activity and, when they do, these crimes are more serious than crimes committed by other individuals; (iv) individuals with ADHD use both the primary and the secondary health-care sector more than average, and their medicine costs are higher than average.Less
The chapter presents descriptive statistics about two patient groups. The areas shown are: family background, labour-market attainment, criminal history, traffic accidents, childhood outcomes, family situation, and general health care. The statistics show that (i) parents of individuals with ADHD are younger and earn less than parents of the average person in the rest of the population; (ii) individuals who have ADHD on average have less education, are more likely to be out of the labour force, and earn significantly less than members of the general population; (iii) persons with ADHD are more likely to engage in criminal activity and, when they do, these crimes are more serious than crimes committed by other individuals; (iv) individuals with ADHD use both the primary and the secondary health-care sector more than average, and their medicine costs are higher than average.