National Medical Care Expenditure Research Articles

Women and divorce: health insurance coverage, utilization, and health care expenditures.

Estimates from the 1977 National Medical Care Expenditure Survey suggest that divorced women are twice as likely as married women to be uninsured, and also more likely to depend on Medicaid assistance. Divorced women use slightly more health services than married women, but also appear to have somewhat poorer health status.

Knowledge of their health insurance coverage by the elderly.

Current legislative proposals to increase competition among private insurers assume that people are or can be well-informed about their insurance coverage. Evidence from the National Medical Care Expenditure Survey shows that among the population 65 years of age and older knowledge about health insurance coverage is substantial but generally lower than in the population younger than 65 years of age. Multivariate analysis is used to identify factors associated with high and low levels of knowledge. Although correct knowledge of coverage of particular services is highly associated with current experience of health problems, with use of these health services, and with the cost for private insurance, overall knowledge is lowest among some groups at high risk of serious illness, in particular, the old, nonwhites, and persons enrolled in Medicare but without Medicaid or private insurance supplements.

Methodological Issues in Health Surveys

The National Medical Care Expenditure Survey (NMCES) is one of the most comprehen sive health surveys ever conducted by the federal government. NMCES used a series of procedures designed to increase the quality and accuracy of the data. Since many of these procedures are expensive and time-consuming, often survey researchers must choose between alternative bias reducing strategies. This article presentsfindingsfrom a series of methodological studies conducted to evaluate issues such as response bias, organizational effects, the effect of improved response rates, and the usefulness of surveys of medical providers and health insurers to supplement the data collected in a household health survey. The results of these investigations should prove useful in the design of future surveys.

Procedures and Questionnaires of the National Medical Care Utilization and Expenditure Survey.

Procedures and Questionnaires of the National Medical Care Utilization and Expenditure Survey.

Health insurance for the unemployed: is federal legislation needed?

Prologue: With more than 10 percent of the work force unemployed last spring, Congress seemed prepared to enact, over the objections of the Reagan administration, a new federal entitlement program extending health insurance coverage to those individuals who had lost their jobs. Such legislation, backed by Democrats and Republicans alike, cleared the House of Representatives in August, providing $4 billion for a state-administered program of health insurance for the unemployed. Since then, however, the House-passed bill and more modest proposals introduced in the Senate, have languished as a consequence of an improving economy and mounting concern over the massive budget deficits that loom into the indefinite future. But beyond these factors, another consideration emerged: legislators were uncertain about how best to address the issue. Contributing to their unease was a new study underwritten by the National Center for Health Services Research which showed that only 13 percent of the unemployed in 1982 were without health insurance because they were out of work. The study was based upon data taken from the National Medical Care Expenditure Survey, as updated by the 1982 population census. The study shows that most of the unemployed retained health insurance coverage through protection provided by a spouses plan. The authors agreed that being without health insurance coverage is a serious problem for part of the labor force, but most of these individuals are employed. Thus, the study concludes that a new federal program which focuses only on the unemployed might not only displace private efforts to protect these individuals but would raise serious equity issues as well. Alan Monheit and Michael Hagan are economists at the National Center for Health Services Research (NCHSR); Marc Berk is a sociologist at the same federal agency. Gail Wilensky, an economist who formerly worked at NCHSR, is now vice-president of Project HOPE's domestic division.

Prescribed medicines: findings from the National Medical Care Expenditure Survey.

In 1977 the National Center for Health Services Research, US Department of Health and Human Services, undertook a survey of 40,000 individuals in the United States, soliciting information on expenditures and sources of payment for health services including prescribed medicines. Differences in the use of prescribed medicines by age, sex, ethnic/racial background, family income, and perceived health status were found across and within therapeutic categories. More than one-fifth of expenditures were for cardiovascular-renal agents. Sources of payment were similar in all but a few therapeutic categories.

Family Roles, Structure, and Stressors in Relation to Sex Differences in Obtaining Psychotropic Drugs

Although it is well-documented that women are more likely than men to use prescribed psychotropic drugs, there are conflicting explanations of this pattern. The purpose of this paper is to examine this sex difference in relation to three theoretical perspectives: (1) the sex-role theory, (2) social support theory, and (3) stress theory. Data from the National Medical Care Expenditure Survey confirm that women were more likely than men to obtain a psychotropic drug. The data also showed that for both men and women, the likelihood of obtaining a psychotropic drug is influenced by family role responsibilities, family structure, and stressful events. However, women had a significantly higher likelihood of use than men under similar family circumstances. When sociodemographic and health-statuslaccess-to-care variables were controlled, the association for men between family circumstances and obtaining a psychotropic drug disappeared. For women, however, certain family role responsibilities, structures, and stressful events significantly affected the likelihood of obtaining a psychotropic drug even when sociodemographic and health-statuslaccess-to-care variables were controlled.

Expenditures for Dental Services: Findings from the National Medical Care Expenditure Survey

Current financing mechanisms and resulting payment patterns influence the number of persons receiving dental care and the types of service received. This paper shows the findings from the National Medical Care Expenditure Survey for the calendar year 1977.

Estimated Data Collection Organization Effect in the National Medical Care Expenditure Survey

Estimated Data Collection Organization Effect in the National Medical Care Expenditure Survey

Estimated Data Collection Organization Effect in the National Medical Care Expenditure Survey

Abstract The National Medical Care Expenditure Survey, which has a complex survey design, is further complicated by combining two independently drawn national samples of households from the Research Triangle Institute (RTI) and the National Opinion Research Center (NORC). It is assumed that since the structures of these national-area samples are similar, they are thereby compatible and allow for the derivation of statistically equivalent unbiased national estimates of relevant health parameters. In this paper, national parameter estimates of relevant demographic and health measures were separately produced for each of the two survey organizations and a determination was made regarding statistical equivalence across samples. In addition, the data-collection organization effect was estimated and tested within the framework of a multivariate analysis appropriate for complex survey data. The findings consistently revealed a statistically nonsignificant data-collection organization effect when testing for diff...

National Medical Care Expenditure Survey.

National Medical Care Expenditure Survey.

Estimation of Life Expectancy by Mathematical Models

Annual changes of life expectancy at birth for males and females in Japan during the 1950-1976 period agree well with Gompertz curves. They also agree well with logistic curves as well as modified exponential curves. However, final values are slightly different among these three mathematical models. An equation was attained between life expectancy at birth and per capita national medical care expenditure during the abovementioned period in Japan. Factors affecting life expectancy at birth are discussed with special reference to regular decline of mortality. By means of Gompertz model, a prediction of future age-specific life expectancy was performed. Expected values mostly agree well with Hishinuma's estimations derived from the lowest mortality in 1974 in the world and a modified 1975 Japanese life table.