This project will use data from the Medical Expenditure Panel Survey (MEPS) to study how health care market structure and the structure of the safety net affects access to and utilization of medical care by uninsured persons. Specifically, the project will use the MEPS to examine the effects of health care market structure and the safety net on whether uninsured persons have a usual source of care and on multiple measures of utilization including physician visits, non-physician visits, hospital admissions and total hospital nights, home health care visits, use of the emergency room, use of preventative care, use of prescription medicines, and total medical care expenditures. The major methodological innovation in the project will be the use of highly detailed measures of the safety net that include the distance form individual uninsured persons to different types of safety net providers. In addition, the project will explore alternative approaches to modeling use in order to account for the dynamics in health insurance.

Agency
National Institute of Health (NIH)
Institute
Agency for Healthcare Research and Quality (AHRQ)
Type
Research Program Projects (P01)
Project #
5P01HS010770-03
Application #
6602717
Study Section
Special Emphasis Panel (ZHS1)
Project Start
2002-07-01
Project End
2003-06-30
Budget Start
Budget End
Support Year
3
Fiscal Year
2002
Total Cost
Indirect Cost
Name
Rand Corporation
Department
Type
DUNS #
City
Santa Monica
State
CA
Country
United States
Zip Code
90401
Escarce, Jose J; Kapur, Kanika (2009) Do patients bypass rural hospitals? Determinants of inpatient hospital choice in rural California. J Health Care Poor Underserved 20:625-44
Gresenz, Carole Roan; Rogowski, Jeannette; Escarce, Jose J (2009) Community demographics and access to health care among U.S. Hispanics. Health Serv Res 44:1542-62
Gresenz, Carole Roan; Rogowski, Jeannette; Escarce, Jose J (2008) Individuals'use of care while uninsured: effects of time since episode inception and episode length. J Natl Med Assoc 100:1394-404
Bao, Yuhua; Fox, Sarah A; Escarce, Jose J (2007) Socioeconomic and racial/ethnic differences in the discussion of cancer screening: ""between-"" versus ""within-"" physician differences. Health Serv Res 42:950-70
Kapur, Kanika; Rogowski, Jeannette A; Freedman, Vicki A et al. (2006) Socioeconomic status and medical care expenditures in Medicare managed care. J Health Care Poor Underserved 17:876-98