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儿童健康保险计划(SCHIP)对儿童保险覆盖范围的影响。

The impact of SCHIP on insurance coverage of children.

作者信息

Hudson Julie L, Selden Thomas M, Banthin Jessica S

机构信息

Division of Modeling and Simulation, Center for Financing, Access and Cost Trends, Agency for Healthcare Research and Quality, Rockville, MD 20850, USA.

出版信息

Inquiry. 2005 Fall;42(3):232-54. doi: 10.5034/inquiryjrnl_42.3.232.

Abstract

In this paper we use the Medical Expenditure Panel Survey between 1996 and 2002 to investigate the impact of the State Children's Health Insurance Program (SCHIP) on insurance coverage for children. We explore a range of alternative estimation strategies, including instrumental variables and difference-in-trends models. We find that SCHIP had a significant impact in decreasing uninsurance and increasing public insurance for both children targeted by SCHIP and those eligible for Medicaid. With respect to changes in private coverage our results are less conclusive: some specifications resulted in no significant effect of SCHIP on private insurance coverage, while others showed significant decreases in private insurance. Associated estimates of SCHIP crowd-out had wide confidence intervals and were sensitive to estimation strategy.

摘要

在本文中,我们利用1996年至2002年的医疗支出小组调查来研究儿童健康保险计划(SCHIP)对儿童保险覆盖范围的影响。我们探索了一系列替代估计策略,包括工具变量法和趋势差异模型。我们发现,SCHIP对减少未参保情况以及增加SCHIP目标儿童和符合医疗补助资格儿童的公共保险覆盖率都产生了重大影响。关于私人保险覆盖范围的变化,我们的结果不太确定:一些设定显示SCHIP对私人保险覆盖范围没有显著影响,而另一些则显示私人保险显著减少。SCHIP挤出效应的相关估计置信区间很宽,并且对估计策略很敏感。

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