Cost-sharing for emergency care and unfavorable clinical events: Findings from the safety and financial ramifications of ED copayments study

Health Services Research

Volumn 41, Issue 5, 2006, Pages 1801-1820

  Hsu, John ^a   Price, Mary ^a   Brand, Richard ^b   Ray, G Thomas ^a   Fireman, Bruce ^a   Newhouse, Joseph P ^c   Selby, Joseph V ^a  

^a DIVISION OF RESEARCH   (United States)

^b UNIVERSITY OF CALIFORNIA   (United States)

^c HARVARD MEDICAL SCHOOL   (United States)

Author keywords

Access demand utilization of services; Health care financing insurance premiums; Incentives in health care; Observational data quasi experiments

Indexed keywords

ARTICLE; CONFIDENCE INTERVAL; COST EFFECTIVENESS ANALYSIS; EMERGENCY CARE; EMPLOYER; HAZARD ASSESSMENT; HEALTH CARE DELIVERY; HEALTH INSURANCE; HEALTH PLAN EMPLOYER DATA AND INFORMATION SET; HOSPITAL ADMISSION; HOSPITALIZATION; HUMAN; INTENSIVE CARE UNIT; LONGITUDINAL STUDY; MEDICARE; POISSON DISTRIBUTION; PROSPECTIVE PAYMENT; PROSPECTIVE PRICING;

COST SHARING; DEDUCTIBLES AND COINSURANCE; DELIVERY OF HEALTH CARE, INTEGRATED; EMERGENCY SERVICE, HOSPITAL; HEALTH SERVICES; HEALTH SERVICES RESEARCH; HOSPITALIZATION; HUMANS; INSURANCE, HEALTH; INTENSIVE CARE UNITS; LONGITUDINAL STUDIES; MORTALITY;

EID: 33748939941     PISSN: 00179124     EISSN: 14756773     Source Type: Journal    
DOI: 10.1111/j.1475-6773.2006.00562.x     Document Type: Article

References (35)

1. Ash, A. S., R. P. Ellis, G. C. Pope, J. Z. Ayania, D.W. Bates, H. Burstin, L. I. Iezzoni, E. MacKay, and W. Yin. 2000. "Using Diagnoses to Describe Populations and Predict Costs." Health Care Financing Review 21 (3): 7-28.
2. Ayanian, J. Z., B. A. Kohler, T. Abe, and A. M. Epstein. 1993. "The Relation between Health Insurance Coverage and Clinical Outcomes among Women with Breast Cancer." New England Journal of Medicine 329: 326-31.
3. Baker, D. W., J. J. Sudano, J. M. Albert, E. A. Borawski, and A. Dor. 2001. "Lack of Health Insurance and Decline in Overall Health in Late Middle Age." New England Journal of Medicine 345: 1106-12.
4. Blustein, J. 1995. "Medicare Coverage, Supplemental Insurance, and the Use of Mammography by Older Women." New England Journal of Medicine 332 (17): 1138-43.
5. Braveman, P., V. Schaaf, S. Egerter, T. Bennett, and W. Schecter. 1994. "Insurance-Related Differences in the Risk of Ruptured Appendix." New England Journal of Medicine 331 (7): 444-9.
6. Fisher, E. S., and H. G. Welch. 1999. "Avoiding the Unintended Consequences of Growth in Medical Care: How Might More Be Worse?" Journal of the American Medical Association 281 (5): 446-53.
7. Fisher, E. S., D. E. Wennberg, T. A. Stukel, D. J. Gottlieb, F. L. Lucas, and E. L. Pinder. 2003. "The Implications of Regional Variations in Medicare Spending. Part 2: Health Outcomes and Satisfaction with Care." Annals of Internal Medicine 138 (4): 288-98.
8. Imbens, G. W. 1999. "The Role of Propensity Score in Estimating Dose-Response Functions." NEBR Working Paper T0237.
9. Institute of Medicine. 2001. Coverage Matters: Insurance and Health Care. Washington, DC: National Academy Press.
10. Joffe, M. M., and P. R. Rosenbaum. 1999. "Invited Commentary: Propensity Scores." American Journal of Epidemiology 150 (4): 327-33.
11. Keeler, E. B., R. H. Brook, G. A. Goldberg, C. J. Kamberg, and J. P. Newhouse. 1985. "How Free Care Reduced Hypertension in the Health Insurance Experiment." Journal of the American Medical Association 254 (14): 1926-31.
12. Krieger, N. 1992. "Overcoming the Absence of Socioeconomic Data in Medical Records: Validation and Application of a Census-Based Methodology." American Journal of Public Health 82 (5): 703-10.
13. Krieger, N., and D. Gordon. 1999. "Re: 'Use of Census-Based Aggregate Variables to Proxy for Socioeconomic Group: Evidence from National Samples'." American Journal of Epidemiology 150 (8): 892-6.
14. Lohr, K. N., R. H. Brook, C. J. Kamberg, G. A. Goldberg, A. Leibowitz, J. Keesey, D. Reboussin, and J. P. Newhouse. 1986. "Use of Medical Care in the RAND Health Insurance Experiment: Diagnosis and Service Specific Analyses in a Randomized Controlled Trial." Medical Care 24 (suppl 9): S1-87.
15. Lurie, N., C. J. Kamberg, R. H. Brook, E. B. Keeler, and J. P. Newhouse. 1989. "How Free Care Improved Vision in the Health Insurance Experiment." American Journal of Public Health 79 (5): 640-2.
16. Magid, D. J., T. D. Koepsell, N. R. Every, J. S. Martin, D. S. Siscovick, E. H. Wagner, and W. D. Weaver. 1997. "Absence of Association between Insurance Copayments and Delays in Seeking Emergency Care among Patients with Myocardial Infarction." New England Journal of Medicine 336 (24): 1722-9.
17. McWilliams, J. M., A. M. Zaslavsky, E. Meara, and J. Z. Ayanian. 2003. "Impact of Medicare Coverage on Basic Clinical Services for Previously Uninsured Adults." Journal of the American Medical Association 290: 757-76.
18. Newhouse, J. P. and The Insurance Experiment Group. 1993. Free for All? Lessons from the RAND Health Insurance Experiment. Cambridge, MA: Harvard University Press.
19. O'Grady, K. F., W. G. Manning, J. P. Newhouse, and R. H. Brook. 1985. "The Impact of Cost Sharing on Emergency Department Use." New England Journal of Medicine 313 (8): 484-90.
20. Phelps, C. E. 1992. Health Economics. New York: HarperCollins Publishers.
21. Reed, M., V. Fung, R. Brand, B. H. Fireman, J. P. Newhouse, J. V. Selby, and J. Hsu. 2005. "Care-Seeking Behavior in Response to Emergency Department Copayments." Medical Care 43 (8): 810-6.
22. Reid, M. C., R. T. Schoen, J. Evans, J. C. Rosenberg, and R. I. Horwitz. 1998. "The Consequences of Overdiagnosis and Overtreatment of Lyme Disease: An Observational Study." Annals of Internal Medicine 128 (5): 354-62.
23. Rubin, D. B. 1997. "Estimating Causal Effects from Large Data Sets Using Propensity Scores." Annals of Internal Medicine 127 (8, part 2): 757-63.
24. Rubin, R. J., and D. N. Mendelson. 1995. "Cost Sharing in Health Insurance." New England Journal of Medicine 333 (11): 733-4.
25. Selby, J. V., B. H. Fireman, R. J. Lundstrom, B. E. Swain, A. F. Truman, C. C. Wong, E. S. Froelicher, H. V. Barron, and M. A. Hlatky. 1996. "Variation among Hospitals in Coronary-Angiography Practices and Outcomes after Myocardial Infarction in a Large Health Maintenance Organization." New England Journal of Medicine 335 (25): 1888-96.
26. Selby, J. V., B. H. Fireman, and B. E. Swain. 1996. "Effect of a Copayment on Use of the Emergency Department in a Health Maintenance Organization." New England Journal of Medicine 334 (10): 635-41.
27. Selby, J. V., and D. Zhang. 1995. "Risk Factors for Lower Extremity Amputation in Persons with Diabetes." Diabetes Care 18 (4): 509-16.
28. Shapiro, M. F., J. E. Ware Jr., and C. D. Sherbourne. 1986. "Effects of Cost Sharing on Seeking Care for Serious and Minor Symptoms." Annals of Internal Medicine 104 (2): 246-51.
29. Siu, A. L., F. A. Sonnenberg, W. G. Manning, G. A. Goldberg, E. S. Bloomfield, J. P. Newhouse, and R. H. Brook. 1986. "Inappropriate use of Hospitals in a Randomized Trial of Health Insurance Plans." New England Journal of Medicine 315 (20): 1259-66.
30. Solanki, G., H. H. Schauffler, and L. S. Miller. 2000. "The Direct and Indirect Effects of Cost-Sharing on the Use of Preventive Services." Health Services Research 34 (6): 1331-50.
31. Weissman, J. S., C. Gatsonis, and A. M. Epstein. 1992. "Rates of Avoidable Hospitalization by Insurance Status in Massachusetts and Maryland." Journal of the American Medical Association 268 (17): 2388-94.
32. Wennberg, J. E., J. L. Freeman, R. M. Shelton, and T. A. Bubolz. 1989. "Hospital Use and Mortality among Medicare Beneficiaries in Boston and New-Haven." New England Journal of Medicine 321 (17): 1168-73.
33. Wong, M. D., R. Andersen, C. D. Sherbourne, R. D. Hays, and M. F. Shapiro. 2001. "Effects of Cost Sharing on Care Seeking and Health Status: Results from the Medical Outcomes Study." American Journal of Public Health 91 (11): 1889-94.
34. Zhao, Y., R. P. Ellis, A. Ash, D. Calabrese, J. Z. Ayanian, J. P. Slaughter, L. Weyuker, and B. Bowen. 2001. "Measuring Population Health Risks Using Inpatient Diagnoses and Outpatient Pharmacy Data." Health Services Research 36 (6, part II): 180-93.
35. Zweifel, P., and W. G. Manning. 2000. "Moral Hazard and Consumer Incentives in Health Care." In Handbook of Health Economics, edited by A. J. Culyer and J. P. Newhouse, edition 1, volume 1, chapter 8, pp. 409-59. Amsterdam: Elsevier.