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Health care utilization among Medicare-Medicaid dual eligibles: a count data analysis

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  • Health care utilization among Medicare-Medicaid dual eligibles: a count data analysis
  • Moon, Sangho; Shin, Jaeun문상호, 신자은
  • BioMed Central


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Title Health care utilization among Medicare-Medicaid dual eligibles: a count data analysis
Similar Titles
Material Type Articles
Author(English)

Moon, Sangho; Shin, Jaeun

Author(Korean)

문상호, 신자은

Publisher

BioMed Central

Date 2006
Journal Title; Vol./Issue BMC Public Health:Vol. 6 Issue 88
Language English
File Type Link
Subject Social Development < Health
Holding BioMed Central

Abstract

Background
Medicare-Medicaid dual eligibles are the beneficiaries of both Medicare and Medicaid. Dual eligibles satisfy the eligibility conditions for Medicare benefit. Dual eligibles also qualify for Medicaid because they are aged, blind, or disabled and meet the income and asset requirements for receiving Supplement Security Income (SSI) assistance. The objective of this study is to explore the relationship between dual eligibility and health care utilization among Medicare beneficiaries.

Methods
The household component of the nationally representative Medical Expenditure Panel Survey (MEPS) 1996–2000 is used for the analysis. Total 8,262 Medicare beneficiaries are selected from the MEPS data. The Medicare beneficiary sample includes individuals who are covered by Medicare and do not have private health insurance during a given year. Zero-inflated negative binomial (ZINB) regression model is used to analyse the count data regarding health care utilization: office-based physician visits, hospital inpatient nights, agency-sponsored home health provider days, and total dental visits.

Results
Dual eligibility is positively correlated with the likelihood of using hospital inpatient care and agency-sponsored home health services and the frequency of agency-sponsored home health days. Frequency of dental visits is inversely associated with dual eligibility. With respect to racial differences, dually eligible Afro-Americans use more office-based physician and dental services than white duals. Asian duals use more home health services than white duals at the 5% statistical significance level. The dual eligibility programs seem particularly beneficial to Afro-American duals.

Conclusion
Dual eligibility has varied impact on health care utilization across service types. More utilization of home healthcare among dual eligibles appears to be the result of delayed realization of their unmet healthcare needs under the traditional Medicare-only program rather than the result of overutilization in response to the expanded benefits of the dual eligibility program. The dual eligibility program is particularly beneficial to Asian and Afro-American duals in association with the provision of home healthcare and dental benefits.