Private health insurance coverage and disability among older Americans |
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Authors: | LR Landerman GG Fillenbaum CF Pieper GL Maddox DT Gold JM Guralnik |
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Affiliation: | Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, USA. lrl@geri.duke.edu |
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Abstract: | OBJECTIVES: This study examines the relationship between the lack of private supplemental health insurance coverage and the development of disability among adults aged 65 and older. METHODS: Data are from the baseline and six follow-up waves of the Duke Established Populations for Epidemiologic Studies of the Elderly survey (N = 4,000). Discrete-time hazard models were used to estimate the impact of insurance coverage and other risk factors on the incidence of disability among those unimpaired at baseline. RESULTS: Controlling for education, income, and other potential confounders, the odds of developing disability were 35-49% higher among those without private coverage. Insurance coverage also statistically explained part of the increased risk of disability among low-income persons. DISCUSSION: The results indicate that changes in health insurance coverage as well as in individual behaviors may be needed to reduce disability generally and disability among the socioeconomically disadvantaged, in particular. |
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