Brett O’Hara and Kyle Caswell
The national health spending for Americans has increased in recent years and is projected to continue on a rapid growth trajectory. This phenomenon is subject to the interplay of many forces, both demographic and economic. People are living longer, have declining health status for more years than in the past, and are consuming more medical services. Regardless of demographic characteristics, health insurance coverage affects medical service utilization and cost. Uninsured people more often forgo or delay medical services compared with people who have health insurance coverage. Further, uninsured people are more costly to the health care system than are insured people.
This report examines the relationship between medical services utilization, health status, health insurance coverage, and other demographic and economic characteristics. Measurement of medical services utilization includes the frequency of visits to medical doctors, nurses, and other medical providers; visits to dentists and dental professionals; nights spent in a hospital; and use of prescription medication. Data about health status are self-reported, where respondents rate their health according to one of five possible response categories: “excellent,” “very good,” “good,” “fair,” or “poor.” The demographic and economic characteristics studied in this report include sex, race and ethnicity, age, family income, and insurance status. These demographic and economic characteristics may not have a causal relationship to health status and medical services utilization.
This report uses data from the Survey of Income and Program Participation (SIPP), a nationally representative longitudinal survey of the civilian noninstitutionalized U.S. population. The SIPP includes a core set of questions and topical modules. In the core, respondents are asked a variety of questions on their health insurance coverage, income, and demographic characteristics. In addition to the core, this report focuses on a topical module on medical expenses and utilization of health care. The data come from the 2001, 2004, and 2008 SIPP panels, covering the years 2001, 2002, 2003, 2004, 2005, 2009, and 2010. Most of this report’s data were collected from September through December 2010 during the seventh interview of the 2008 SIPP. For more information on the SIPP, see the Source of the Data section at the end of this report.
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