Contents

Health Care Utilization among Medicare-Medicaid Dual Eligibles: a Count Data Analysis

Moon, Sangho / Shin, Ja Eun

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.

Issue Date
2006-04
Publisher
BIOMED CENTRAL LTD
Keywords
Incidence Rate Ratio; Home Health; Medicare Beneficiary; Medical Expenditure Panel Survey; Dental Service; DATA MODELS
Citation
BMC PUBLIC HEALTH, v.6, no.1, 2006
DOI
10.1186/1471-2458-6-88
Journal Title
BMC PUBLIC HEALTH
ISSN
1471-2458
Language
English
Files in This Item:
    There are no files associated with this item.

Click the button and follow the links to connect to the full text. (KDI CL members only)

qrcode

Items in DSpace are protected by copyright, with all rights reserved, unless otherwise indicated.