Impact of a Private Health Insurance Mandate on Public Sector Autism Service Use in Pennsylvania

2012 ◽  
Vol 51 (8) ◽  
pp. 771-779 ◽  
Author(s):  
Bradley D. Stein ◽  
Mark J. Sorbero ◽  
Upasna Goswami ◽  
James Schuster ◽  
Douglas L. Leslie
Keyword(s):  
Health Insurance ◽  
Public Sector ◽  
Private Health Insurance ◽  
Service Use ◽  
Insurance Mandate

scholarly journals Has the increase in private health insurance uptake affected the Victorian public hospital surgical waiting list?

2002 ◽  
Vol 25 (6) ◽  
pp. 64 ◽  
Author(s):  
Brian Hanning
Keyword(s):  
Health Insurance ◽  
Public Sector ◽  
Private Sector ◽  
Uptake Rate ◽  
Public Hospital ◽  
Private Health Insurance ◽  
Elective Surgery ◽  
Waiting List ◽  
Limited Data ◽  
The Public

It was anticipated that increased uptake of Private Health Insurance (PHI) would reduce demand on public sector surgical waiting lists. The best measure of changed demand is the comparison of the actual cases added to that projected given previous trends in PHI uptake. Detailed Victorian data is available up to 2000-1.The total waiting list has varied little, reflecting significant decreases in both in patients added to and removed. There was a marked increase in private sector elective surgery cases coinciding with the fall in additions to the public sector waiting list and in public sector elective surgical cases. The June 2001 Victorian surgical waiting list would have been 69,599 not 41,838 if the PHI uptake rate had continued to fall in line with pre-1999 trends, and that of June 2002 about 100,000 compared to 40,458 in March 2002.Limited data from other states suggests the Victorian trends are representative of all Australia.

scholarly journals The profiles of public and private patients in maternal healthcare: a longitudinal study to examine adverse selection

2019 ◽  
Vol 14 (1) ◽  
pp. 129-137
Author(s):  
Jananie William ◽  
Bronwyn Loong ◽  
Catherine Chojenta ◽  
Deborah Loxton
Keyword(s):  
Health Insurance ◽  
Adverse Selection ◽  
Financial Incentives ◽  
Private Health Insurance ◽  
Service Use ◽  
Subsequent Pregnancy ◽  
Two Phase ◽  
Related Factors ◽  
Private Patient ◽  
The Impact

AbstractIn this article, we investigate differences in the profiles of patients within the Australian mixed public-private maternal health system to examine the extent of adverse selection. There are conflicting influences on adverse selection within the private health sector in Australia due to government regulations that incentivise lower risk segments of the population to purchase community-rated private health insurance. We use a two-phase modelling methodology that incorporates statistical learning and logistic regression on a dataset that links administrative and longitudinal survey data for a large cohort of women. We find that the key predictor of private patient status is having private health insurance, which itself is largely driven by sociodemographic factors rather than health-or pregnancy-related factors. Additionally, transitioning between the public-private systems for a subsequent pregnancy is uncommon; however, it is primarily driven by changes in private health insurance when it occurs. Other significant factors when transitioning to the private system for a second pregnancy are hypertension, increased access to specialists and stress related to previous motherhood experiences. Consequently, there is limited evidence of adverse selection in this market, with targeted financial incentives likely outweighing the impact of community rating even during childbearing years where private health service use increases.

Private health insurance, mental health and service use in Australia

2012 ◽  
Vol 46 (5) ◽  
pp. 468-475 ◽  
Author(s):  
Liana S Leach ◽  
Peter Butterworth ◽  
Harvey Whiteford
Keyword(s):  
Mental Health ◽  
Health Insurance ◽  
Private Health Insurance ◽  
Service Use

scholarly journals Use of pharmacy services in community-dwelling middle-aged and older adults in Ireland

2021 ◽  
Vol 29 (Supplement_1) ◽  
pp. i4-i5
Author(s):  
F Moriarty ◽  
M Flood
Keyword(s):  
Blood Pressure ◽  
Older Adults ◽  
Health Insurance ◽  
Educational Attainment ◽  
Private Health Insurance ◽  
Service Use ◽  
Community Dwelling ◽  
Pharmacy Service ◽  
Pharmacy Services ◽  
Gp Visits

Abstract Introduction Pharmacy has a potentially significant role in meeting the escalating need for healthcare, particularly with population ageing and shifts to more community-based care under Ireland’s health reform policies. The role of community pharmacists has evolved in recent years with expansion in pharmacy services offered. This study aims to assess pharmacy services use among adults aged ≥50 years in Ireland, and determine the demographic and clinical factors associated with pharmacy services use. Methods This cross-sectional study included community-dwelling participants in wave 4 of The Irish Longitudinal Study on Ageing (TILDA), aged ≥50 years who were self-respondents (i.e. proxy respondents were omitted). TILDA is a nationally representative cohort study, and wave 4 data was collected during 2016. TILDA participants were asked if they availed of several named services when visiting the pharmacy in the last 12 months. These included: requesting advice about medication; vaccination; blood pressure (BP) or cholesterol checks; advice on smoking cessation or weight management; and diabetes, asthma, or allergy tests. We considered age, sex, educational attainment, GP utilization, medical card and private health insurance status, loneliness, polypharmacy, use of high risk medications (anticoagulants, NSAIDs, opioids, diuretics, antiplatelets, antimicrobials, insulin and hypoglycaemics) and comorbidities. Multivariate logistic regression was used to examine the association of these with reporting (i) any pharmacy service use and (ii) requesting medicines advice. Results This study included 5,782 participants, 55.5% were female with a mean age of 68 years. 96.6% of participants (5,587) reporting visiting a pharmacy in the previous 12 months, and almost one quarter of these (1,323) availed of at least one specified pharmacy service. The most common services reported were requesting advice about medications (786, 13.6%), blood pressure monitoring (184, 3.2%), and vaccination (166, 2.9%). Compared to those not using any services, service users were a similar age (mean 68 years), but were taking more medications (mean 3.6 versus 2.8), were more often female (64.1% versus 54.2%), had higher educational attainment, and had higher GP visit rates. Controlling for other factors, the following were associated with a high likelihood of availing of pharmacy services: female gender (odds ratio (OR) 1.32, 95%CI 1.14–1.52), third level education (OR 1.85, 95%CI 1.51–2.27), higher rates of GP visits, private health insurance (OR 1.29, 95%CI 1.07–1.56), higher number of medications, loneliness, and a diagnosed respiratory condition (OR 1.42, 95% CI 1.14–1.74). The relationship between these factors and requesting medicines advice were similar. Conclusion A high proportion of middle-aged and older adults visit community pharmacy and a quarter avail of specified pharmacy services. Despite advances in the services offered in pharmacies, medicines advice remains at the core of pharmacists’ practice. Those on multiple medications, who may derive greater benefit from such services, are more likely to avail of them. Number of GP visits was also associated with service use, suggesting patients may avail of pharmacy services as a complement, rather than a substitute, to visiting their GP. Services were more often used by people who are lonely, and pharmacists should consider interventions to support these people.

scholarly journals Impact on public hospitals if private health insurance rates in Victoria declined

2004 ◽  
Vol 28 (3) ◽  
pp. 330 ◽  
Author(s):  
Brian W T Hanning
Keyword(s):  
Health Insurance ◽  
Public Sector ◽  
Private Health Insurance ◽  
Operating Cost ◽  
Public Hospitals ◽  
Income Loss ◽  
The Public ◽  
Capital Costs ◽  
Recurrent Cost ◽  
Insurance Rates

The additional cost of treating acute care type Victorian private patients as public patients in Victorian public hospitals based on the current public sector payment model and rates was calculated, as was the loss of health fund income to public hospitals. If all private cases became public the net recurrent cost would be $1.05 billion assuming all patients were still treated. If private health insurance (PHI) uptake had declined to 23.3% as was projected without Lifetime Health Cover and the 30% rebate, the additional operating cost and income loss would be $385 million. This compares to the Victorian cost of the 30% rebate for acute hospital cases of $383 million. This takes no account of capital costs and possible public sector access problems. The analysis suggests that 31 extra operating theatres would be needed in the public sector (had the transfer of surgical patients from the public sector to the private sector not occurred). This analysis suggests that without the PHI rebate the current stresses on Victorian public hospitals would be increased, not decreased.

scholarly journals Association of mammography with sociodemographic and care factors in residents of Belo Horizonte, MG, Brazil

Mastology ◽  
2020 ◽  
Vol 30 ◽  
Author(s):  
Amanda Silva Magalhães ◽  
Bruno de Souza Moreira ◽  
Dário Alves da Silva Costa ◽  
Amanda Cristina de Souza Andrade ◽  
Waleska Teixeira Caiaffa
Keyword(s):  
Health Insurance ◽  
Cancer Screening ◽  
Private Health Insurance ◽  
Service Use ◽  
Pap Smear ◽  
Family Income ◽  
Vulnerable Groups ◽  
Cluster Sampling ◽  
Access To Health Services ◽  
Belo Horizonte

Objective: This study aimed to investigate screening mammography in the last two years, sociodemographic factors, and healthcare service use among women aged 40–69 years living in a Brazilian urban center. Methods: The data are part of a household survey called “MOVE-SE Academias” (2014/2015) carried out in Belo Horizonte (MG). The sample was selected using a stratified three- stage cluster sampling: Health Academy Program units distributed in the city, census tracts, and households. Pearson’s chi-square test was used in the analysis. Results: Of the 371 women included in this study with a mean age of 52.5 years, 66.2% among those aged 40–49 years (n = 157) and 75.7% among those aged 50–69 years (n = 214) reported being submitted to mammography within two years before the interview. When it comes to women aged 40–49 and 50–69 years, a higher proportion was found among those with higher schooling (p = 0.011 and p = 0.001), who had been to medical appointments in less than one year (p = 0.024 and p < 0.001), who had performed the Pap smear test in less than two years (p < 0.001 for both groups) and who reported having a private health insurance (p = 0.007 and p = 0.008). Higher family income was associated only with the performance of the screening exam among women aged 40–49 years (p = 0.006). Conclusion: Our results suggest inequalities in access to health services for breast cancer screening, modulated by socioeconomic factors, including private health insurance. Prioritizing more vulnerable groups in cancer screening as a public policy can contribute to reducing health inequalities.

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