Seiber Eric E, Sahr Timothy R
Ohio State University-College of Public Health, Columbus, OH 43210, USA.
Medicare Medicaid Res Rev. 2011 Mar 31;1(1):001.01.a01. doi: 10.5600/mmrr.001.01.a01.
OBJECTIVE To estimate substitution from private insurance to public coverage among adult Medicaid enrollees.
2004 and 2008 Ohio Family Health Surveys (OFHS) STUDY DESIGN: Substitution is estimated from respondents' self-reported current insurance coverage and coverage prior to Medicaid enrollment. A linear probability model estimates the association between prior private coverage and respondent characteristics.
DATA COLLECTION/EXTRACTION METHODS: Random digit dialing telephone survey of 50,944 Ohio residents in 2008-2009 and 39,953 in 2003-2004.
Few adult Medicaid enrollees in Ohio voluntarily replace their private coverage with Medicaid. In 2008, only 2.9% of new Medicaid adults voluntarily substituted public for private coverage (4.6% in 2004). Of these 2.9% who voluntarily substituted from private to public coverage, 38% reported that they could not afford their employer sponsored plan. The multivariate results for all private to Medicaid transitions find few significant differences, other than income, in the probability of transition.
Few transitions from private coverage to Medicaid are voluntary, and substitution is a minor issue among current Ohio Medicaid adults.
目的 估计成年医疗补助参保者中从私人保险转为公共保险覆盖的情况。
2004年和2008年俄亥俄州家庭健康调查（OFHS）
根据受访者自我报告的当前保险覆盖情况以及医疗补助参保前的覆盖情况来估计转换情况。线性概率模型估计先前私人保险覆盖与受访者特征之间的关联。
数据收集/提取方法：2008 - 2009年对50,944名俄亥俄州居民进行随机数字拨号电话调查，2003 - 2004年对39,953名居民进行调查。
俄亥俄州很少有成年医疗补助参保者自愿用医疗补助取代其私人保险。2008年，新加入医疗补助的成年人中只有2.9%自愿将公共保险替换为私人保险（2004年为4.6%）。在这2.9%自愿从私人保险转为公共保险的人中，38%报告称他们负担不起雇主提供的保险计划。所有从私人保险转为医疗补助的多变量结果显示，除收入外，转换概率几乎没有显著差异。
从私人保险转为医疗补助的情况很少是自愿的，在当前俄亥俄州成年医疗补助参保者中，转换是一个小问题。
