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Medicare expenditure growth and its health returns across cohorts
Descriptive
TitleInfo
Title
Medicare expenditure growth and its health returns across cohorts
Name
(type = personal)
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(type = family)
Chao
NamePart
(type = given)
Yi-Sheng
NamePart
(type = date)
1981-
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Yi-Sheng Chao
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author
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Monheit
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Alan C
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Alan C Monheit
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Advisory Committee
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chair
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Grafova
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Irina B
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Irina B Grafova
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Advisory Committee
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(authority = RULIB)
internal member
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(type = personal)
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(type = family)
Rogowski
NamePart
(type = given)
Jeannette
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Jeannette Rogowski
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Advisory Committee
Role
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(authority = RULIB)
internal member
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(type = personal)
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(type = family)
Cohen
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(type = given)
Joel W
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Joel W Cohen
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Advisory Committee
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outside member
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Rutgers University
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(authority = RULIB)
degree grantor
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Graduate School - New Brunswick
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school
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Text
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theses
OriginInfo
DateCreated
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2012
DateOther
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2012-10
CopyrightDate
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2012
Place
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xx
Language
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eng
Abstract
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There are several key findings in the following chapters. In Chapter 2, the individual characteristics associated with higher spending growth over the period 1996 to 2008 were identified based on analyses with pooled cross-sectional data from the Medical Expenditure Panel Survey. The key factors that were associated with the adjusted growth rates higher than the actual Medicare spending growth rate (5.8% annually) from 1996 to 2008 include races other than the whites and blacks, Hispanic origin, high income, residence in the West, and very good health status. Findings from Chapter 3 reveal that enrollment in HMOs under Medicare is not random, but is systematically related to characteristics of Medicare enrollees. Using the longitudinal Health and Retirement Study, there were factors associated with a higher likelihood of becoming enrolled in Medicare Advantage/Part C. Chapter 4 examines the relationship between health care spending and returns to health with regard to five dimensions of health: mortality, hypertension, arthritis, self-assessed health status and mental health status (Center for Epidemiologic Studies Depression scale, CESD scale). The pre-Medicare characteristics were used to predict the change in these five dimensions of health after four years of Medicare coverage. The results reveal that increases in Medicare total and out-of-pocket spending were associated with poor health outcomes. Total spending was associated with a higher likelihood of death, worse self-rated health status (five categories) and mental health status. The increase in out-of-pocket health expenditure was associated with a higher chance of getting a worse category in self-rated health status after controlling for health status and other characteristics before being enrolled in Medicare. The findings of these studies suggest that policies to constrain Medicare spending should recognize and target the multiple factors contributing to Medicare expenditure growth and the dubious returns to health, as well as target integrated care for Medicare enrollees and incentives for individuals to prevent the onset of chronic health conditions.
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Public Health
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Rutgers University Electronic Theses and Dissertations
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ETD_4216
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electronic resource
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application/pdf
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Extent
xii, 224 p. : ill.
Note
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Ph.D.
Note
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Includes bibliographical references
Note
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Includes vita
Note
(type = statement of responsibility)
by Yi-Sheng Chao
Subject
(authority = ETD-LCSH)
Topic
Medicare
Subject
(authority = ETD-LCSH)
Topic
Medicare--Finance
Identifier
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http://hdl.rutgers.edu/1782.1/rucore10001600001.ETD.000066649
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Graduate School - New Brunswick Electronic Theses and Dissertations
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rucore19991600001
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doi:10.7282/T3R49PJ5
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ETD doctoral
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Rights
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The author owns the copyright to this work.
RightsHolder
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Name
FamilyName
Chao
GivenName
Yi-Sheng
Role
Copyright Holder
RightsEvent
Type
Permission or license
DateTime
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(point = start)
2012-09-07 13:05:32
AssociatedEntity
Name
Yi-Sheng Chao
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Affiliation
Rutgers University. Graduate School - New Brunswick
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License
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Author Agreement License
Detail
I hereby grant to the Rutgers University Libraries and to my school the non-exclusive right to archive, reproduce and distribute my thesis or dissertation, in whole or in part, and/or my abstract, in whole or in part, in and from an electronic format, subject to the release date subsequently stipulated in this submittal form and approved by my school. I represent and stipulate that the thesis or dissertation and its abstract are my original work, that they do not infringe or violate any rights of others, and that I make these grants as the sole owner of the rights to my thesis or dissertation and its abstract. I represent that I have obtained written permissions, when necessary, from the owner(s) of each third party copyrighted matter to be included in my thesis or dissertation and will supply copies of such upon request by my school. I acknowledge that RU ETD and my school will not distribute my thesis or dissertation or its abstract if, in their reasonable judgment, they believe all such rights have not been secured. I acknowledge that I retain ownership rights to the copyright of my work. I also retain the right to use all or part of this thesis or dissertation in future works, such as articles or books.
RightsEvent
DateTime
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2012-10-31
DateTime
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2014-10-31
Type
Embargo
Detail
Access to this PDF has been restricted at the author's request. It will be publicly available after October 31st, 2014.
Copyright
Status
Copyright protected
Availability
Status
Open
Reason
Permission or license
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