Public Insurance (public + insurance)

Distribution by Scientific Domains


Selected Abstracts


The Political Economy of Postmaterialism: Material Explanations of Changing Values

ECONOMICS & POLITICS, Issue 2 2002
Robert Grafstein
This paper uses a dynamic stochastic general equilibrium (DSGE) model of the US political economy to explore the impact of public insurance on the way individuals react to partisan changes in economic policy. In response to these aggregate political shocks, individuals rely on public insurance to insulate them from government-induced volatility in consumption. As a result, the public appears to be relatively less materialistic in its vote choices as well as in "values" surveys, but only because its underlying materialism has less political salience. Thus this insurance model provides an alternative analysis of the rise of "postmaterialist values" and their relation to unemployment. [source]


Positive health-care effects of an alcohol ignition interlock programme among driving while impaired (DWI) offenders

ADDICTION, Issue 11 2007
Bo Bjerre
ABSTRACT Aims To compare the costs of hospital care and sick leave/disability pensions between two groups of driving while impaired (DWI) offenders: participants in an alcohol ignition interlock programme (AIIP) and controls with revoked licences, but with no comparable opportunity to participate in an AIIP. Setting As an alternative to licence revocation DWI offenders can participate in a voluntary 2-year AIIP permitting the offender to drive under strict regulations entailing regular medical check-ups. The participants are forced to alter their alcohol habits and those who cannot demonstrate sobriety are dismissed from the programme. Participants are liable for all costs themselves. Design Quasi-experimental, with a non-equivalent control group used for comparison; intent-to-treat design. Based on the number of occasions/days in hospital and on sick leave/disability pension, the health-care costs for public insurance have been calculated. Finding Average total health-care costs were 25% lower among AIIP participants (1156 individuals) than among controls (815 individuals) during the 2-year treatment period. This corresponds to over ,1000 (SEK9610) less annual costs per average participant. For those who complete the 2-year programme the cost reduction was more pronounced; 37% during the treatment and 20% during the post-treatment period. Conclusions The positive health-care effects were due apparently to reduced alcohol consumption. The social benefit of being allowed to drive while in the AIIP may also have contributed. The reduction in health-care costs was significant only during the 2-year treatment period, but among those who completed the entire AIIP sustained effects were also observed in the post-treatment period. The effects were comparable to those of regular alcoholism treatment programmes. [source]


Immigrants and the use of preventive care in the United States,

HEALTH ECONOMICS, Issue 7 2009
Yuriy Pylypchuk
Abstract Using data from the Medical Expenditure Panel Survey, we compare immigrants' use of preventive care with that of natives. We employ a multinomial switching regression framework that accounts for non-random selection into continuous private insurance, temporary private insurance, public insurance, and no insurance. Our results indicate that among the populations with continuous private coverage and without coverage (uninsured), immigrants, especially non-citizens, are less likely to use preventive care than natives. We find that the longer immigrants stay in the US the more their use of care approximates to that of natives. However, for most types of care, immigrants' use of care never fully converges to that of natives. Among the publicly insured population, immigrants' use of care is similar to natives, but non-citizen immigrants are significantly less likely to use preventive measures. We find that the ability to speak English does not have a significant effect on the use of preventive care among publicly insured persons. Published in 2008 by John Wiley & Sons, Ltd. [source]


Use of mental health treatment among veterans filing claims for posttraumatic stress disorder

JOURNAL OF TRAUMATIC STRESS, Issue 1 2007
Nina A. Sayer
This study examines predictors of current mental health service use in a sample of 154 veterans filing claims for Veterans Affairs (VA) disability benefits based on Posttraumatic Stress Disorder (PTSD). Our conceptual framework was the behavioral model that classifies predictors of service utilization into predisposing (background), enabling (e.g., insurance) and need (e.g., symptoms) factors. Slightly more than half of the PTSD claimants were receiving mental health treatment at the time of claim initiation. Mean symptom levels were clinically significant in both users and nonusers of mental health treatment. In a multivariate logistic regression analysis, mental health treatment use was associated with younger age, marriage, and dependence on public insurance. Implications for future research are discussed. [source]


Risk factors for low birthweight in north-east Brazil: the role of caesarean section

PAEDIATRIC & PERINATAL EPIDEMIOLOGY, Issue 3 2001
Antônio A.M. Silva
Summary Caesarean section (CS) delivery is associated with low birthweight (LBW) in south-east Brazil. A hospital-based study was conducted on singleton infants from mothers residing in São Luís, to assess if an association between CS and LBW was found in the northern part of the country, where the CS rate is lower than in the south-east. A standardised questionnaire was administered to a sample of 2541 mothers in 10 hospitals, representing 94% of all deliveries, from March 1997 to February 1998. In a logistic model, type of delivery was the independent variable, the other variables were treated as confounders, and interaction terms were added between type of delivery and all other factors. LBW was associated with low maternal height, maternal smoking, primiparity, previous LBW, public insurance, preterm birth and CS. The CS rate was 33.7%. The risk of CS was higher for primiparous and married mothers, those with high level of schooling and attended by the same physician during prenatal and delivery care, deliveries held in private hospitals, daylight hours or evenings, and for those mothers who had adequate prenatal care. Because it appears unlikely that only medical reasons are operative, it is a possibility that CS could cause LBW, reflecting abusive indications for elective CS. [source]


Why do adults entitled to free or highly subsidized dental services select fully out-of-pocket-paid care?

COMMUNITY DENTISTRY AND ORAL EPIDEMIOLOGY, Issue 1 2010
Fariborz Bayat
Bayat F, Vehkalahti MM, Murtomaa H, Tala H. Why do adults entitled to free or highly subsidized dental services select fully out-of-pocket-paid care? Community Dent Oral Epidemiol 2010; 38: 88,95. © 2009 John Wiley & Sons A/S Abstract,,, Objective:, To investigate patients' reasons for selecting a dental clinic given their choice of free or highly-subsidized dental services. Methods:, The study was based on cross-sectional data obtained through phone interviews with adults in Tehran, Iran. The present study included those entitled to free or highly-subsidized dental services (n = 726). The data covered the patients' awareness of subsidized dental services and type of dental clinic for their most recent visit and their reasons for selecting that clinic. Awareness of subsidized dental services was dichotomized as being either aware or unaware of such subsidy. The type of clinic was dichotomized as providing either free or highly-subsidized (FHS) or fully out-of-pocket paid (FOP) services. Free format answers about the subjects' reasons for selecting a particular clinic were later sub-grouped as: convenient access, good technical aspects, good interpersonal aspects, low or reasonable fees, recommendation by a friend, and no reason. Socio-demographic status was based on background. Data analysis included the chi-square test and logistic regression model. Results:, Of the subjects (n = 726), 60% were women and 58% were under 35 years of age. The subjects' mean age was 33.5 years with no difference by gender (P = 0.24) and the majority had public insurance (91%). Of all the subjects, 60% selected FOP. Good interpersonal aspects were the strongest reason for selecting FOP (OR = 4.6), follow by good technical aspects (OR = 2.3). Those subjects who were unaware of their benefit had 4.6 times the odds of selecting FOP. Conclusions:, Despite the opportunity to use highly-subsidized dental services, good interpersonal and good technical aspects lead patients to select private dentists and to pay fully out of pocket. [source]