Stroupe K T, Kinney E D, Kniesner J J
Midwest Center for Health Services and Policy Research; Cooperative Studies Program Coordinating Center, Hines VA Hospital, Hines, IL, USA.
J Policy Anal Manage. 2001 Jun;20(3):525-44. doi: 10.1002/pam.1006.
Job duration patterns are examined for evidence of health insurance-related job lock among chronically ill workers or workers whose family member is chronically ill. Using Cox proportional hazard models to indicate the effect of health insurance and health status on workers' job duration we allow for more general insurance effects than that shown in the existing literature. Data for workers in Indiana predating the Health Insurance Portability and Accountability Act (HIPAA) are used to examine the potential effect of HIPAA on job mobility. Among the workers in this sample who relied on their employer for coverage, chronic illness reduced job mobility by about 40 percent as compared with otherwise similar workers who did not rely on their employer for coverage. Results reported here identify previously under-appreciated job lock among chronically ill workers and workers whose family member is chronically ill, clarify how one best researches job lock, and indicate the potential effect of policies aimed at alleviating job lock and promoting inter-employer worker mobility.
研究工作时长模式,以寻找慢性病患者或家庭成员患有慢性病的工人中与医疗保险相关的工作锁定证据。使用Cox比例风险模型来表明医疗保险和健康状况对工人工作时长的影响,我们考虑到了比现有文献中所示更普遍的保险效应。利用《健康保险流通与责任法案》(HIPAA)之前印第安纳州工人的数据,来检验HIPAA对工作流动性的潜在影响。在这个样本中那些依靠雇主提供保险的工人中,与其他类似的不依靠雇主提供保险的工人相比,慢性病使工作流动性降低了约40%。此处报告的结果确定了慢性病患者以及家庭成员患有慢性病的工人中先前未被充分认识到的工作锁定情况,阐明了如何最好地研究工作锁定,并指出了旨在减轻工作锁定和促进雇主间工人流动的政策的潜在影响。