The Causal Effect of Health Insurance on Utilization and Outcomes in Adults: A Systematic Review of US Studies

@article{Freeman2008TheCE,
  title={The Causal Effect of Health Insurance on Utilization and Outcomes in Adults: A Systematic Review of US Studies},
  author={J. Freeman and S. Kadiyala and J. Bell and Diane P. Martin},
  journal={Medical Care},
  year={2008},
  volume={46},
  pages={1023-1032}
}
Background:No current consensus exists on the causal effect of gaining or losing health insurance on health care utilization and health outcomes. [...] Key Method Research Design:A systematic search of 3 electronic databases (PubMed, JSTOR, EconLit) was performed.Expand
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References

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Is it Really Worse to Have Public Health Insurance Than to Have No Insurance at All? Health Insurance and Adult Health in the United States∗
TLDR
Using prospective cohort data from the 1979 National Longitudinal Survey of Youth, findings suggest that, among the U.S. birth cohorts of 1957 to 1961, the negative relationship between public health insurance and health is not causal, but rather due to prior health and socioeconomic status. Expand
Sicker and Poorer—The Consequences of Being Uninsured: A Review of the Research on the Relationship between Health Insurance, Medical Care Use, Health, Work, and Income
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Although all of the studies reviewed suffer from methodological flaws of varying degrees, there is substantial qualitative consistency across studies of different medical conditions conducted at different times and using different data sets and statistical methods. Expand
Health insurance and health at age 65: implications for medical care spending on new Medicare beneficiaries.
TLDR
Extending insurance coverage to all Americans between the ages of 55 and 64 would improve health and shift people from good-fair-poor health to excellent-very good health at age 65, and possibly reduce total short-term spending by Medicare and Medicaid for newly eligible Medicare beneficiaries, even though more people would enter the program because of increased survival. Expand
Uninsured status and out-of-pocket costs at midlife.
TLDR
The results suggest that the main impact of non-insurance at midlife is not to place the locus of responsibility for costly health care upon individuals, but instead it discourages routine care and transfers the costs of care for severe health events to other payers. Expand
Does medical insurance contribute to socioeconomic differentials in health?
TLDR
The results showed that persons with private insurance do not differ significantly from the uninsured in their self-reported health, physical functioning, or number of chronic conditions, whereas persons with public insurance report significantly worse health and more chronic conditions than the uninsured. Expand
Short-Term Impacts of Coverage Loss in a Medicaid Population: Early Results From a Prospective Cohort Study of the Oregon Health Plan
PURPOSE Medicaid programs in all 50 states recently implemented cost-saving strategies, including benefit reductions, cost sharing, and tightened administrative rules. These changes resulted in lossExpand
DOES PRENATAL CARE IMPROVE BIRTH OUTCOMES? A CRITICAL REVIEW
TLDR
Prenatal care has not been demonstrated to improve birth outcomes conclusively, and policymakers deciding on funding for prenatal care must consider these findings in the context of prenatal care's overall benefits and potential cost-effectiveness. Expand
Lack of health insurance and decline in overall health in late middle age.
TLDR
The lack of health insurance is associated with an increased risk of a decline in overall health among adults 51 to 61 years old. Expand
Effect of Insurance on Mortality in an HIV-Positive Population in Care
TLDR
The results from this model indicate that insurance does have a beneficial effect on outcomes, lowering the probability of 6-month mortality by 71% at baseline and 85% at follow-up. Expand
Book Review: The Effect of Health Insurance on Medical Care Utilization and Implications for Insurance Expansion: A Review of the Literature
TLDR
This literature is quite consistent in finding significant effects of insurance on all types of utilization, and there is some evidence that insurance coverage reduces ambulatory care sensitive hospital admissions for children. Expand
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