Social and Behavioral Sciences Commons^™

Prenatal Care For Undocumented Immigrants: Implications For Policy, Practice, And Ethics, Rachel Fabi

Population Health Research Brief Series

Nearly 250,000 babies are born each year to undocumented immigrant parents in the U.S. These babies are U.S. citizens, but undocumented immigrants are ineligible for most public insurance, making it difficult for them to access prenatal care. This research brief describes restrictive policies related to prenatal care for undocumented immigrants and discusses how these policies affect health care providers and the care they are able to offer pregnant immigrant women.

The Effect Of Disability Insurance On Health Investment: Evidence From The Va Disability Compensation Program, Perry Singleton

Center for Policy Research

I examine whether individuals respond to monetary incentives to detect latent medical conditions. The effect is identified by an amendment to Title 38 that deemed diabetes associated with Agent Orange exposure a compensable disability under the VA’s Disability Compensation program. Since a diagnosis is a requisite for benefit eligibility, and nearly one-third of diabetics remain undiagnosed, the advent of disability insurance may have encouraged the detection of diabetes among the previously undiagnosed population. Evidence from the National Health Interview Survey suggests that the policy increased the prevalence of diabetes by 2.7 percentage points among veterans.

Intergenerational Labor Market And Welfare Consequences Of Poor Health, Thomas J. Kniesner, Anthony T. Losasso

Center for Policy Research

Our research provides new econometric evidence concerning partial economic risk sharing between a frail elderly parent and an adult child. We estimate a jointly determined limited dependent variables system explaining the parent’s entry into a nursing home, the adult child’s visits to the parent, and the adult child’s labor supplied. The time allocation of adult sons is unaffected by a parent’s frail health. Adult daughters who visit a frail elderly parent daily decrease their annual labor supplied by about 1,000 hours annually, largely through labor force non-participation. The implied welfare loss to the daughter from a frail elderly parent in …

Unfinished Business: Inadequate Health Coverage For Privately Insured, Seriously Ill Children, Nancy Swigonski, Eleanor D. Kinney, Deborah A. Freund, Thomas J. Kniesner

Center for Policy Research

During the 1980s and 1990s there were great increases of health insurance coverage for poor children through the Children’s Health Insurance Program (CHIP) and extended Medicaid eligibility. Problems remain for the small number of children with serious medical conditions whose care is a high proportion of total health care expenditures on children. We report on the adequacy of health insurance coverage for a sample of children with serious and rare illnesses treated at the single tertiary care pediatric hospital in Indiana. One-third of privately insured children in our data had inadequate insurance. Compared to families with inadequate health insurance families …

Determinants Of Medical Costs Following A Diagnosis Of Depression, Regina H. Powers, Thomas J. Kniesner, Thomas W. Croghan

Center for Policy Research

Objective: Assess the determinants of medical costs for depressed individuals.

Method: Using medical insurance claims for a population of depressed individuals with employer provided insurance, we estimated multivariate models of the costs for general medical care, exclusive of costs for mental health services, following diagnosis. Explanatory variables included provider choice (psychiatrist or non-physician mental health specialist), treatment choice (medication, psychotherapy, or combination treatment); treatment adequacy as defined by APA guidelines; characteristics of depression symptoms and severity; and other demographic characteristics.

Results: On average, there were increases in the costs for general medical services in the year following diagnosis of a …

Antidepressent Treatment For Depression: Total Charges And Therapy Duration, Deborah G. Dobrez, Catherine A. Melfi, Thomas W. Croghan, Thomas J. Kniesner, Robert L. Obenchain

Center for Policy Research

Background: The economic costs of depression are significant, both the direct medical costs of care and the indirect costs of lost productivity. Empirical studies of antidepressant costeffectiveness suggest that the use of selective serotonin reuptake inhibitors (SSRI) may be no more costly than tricyclic antidepressants (TCA), will improve tolerability, and is associated with longer therapy duration. However the success of depression care usually involves multiple factors, including source of care, type of care, and patient characteristics, in addition to drug choice. The cost-effective mix of antidepressant therapy components is unclear.

Aims of the Study: Our study evaluates cost and antidepressant-continuity …