The Impact of High Deductible Health Plans on Preventive Care Use
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Issue Date
2015
Authors
Wright, Daniel John '15
Degree
MS in Health Outcomes Research
Advisor
Parker, Wendy
Committee Members
Polimeni, John
Chandrasekara, Ray
Meek, Patrick
Chandrasekara, Ray
Meek, Patrick
Journal Title
Journal ISSN
Volume Title
Abstract
Background: With rising health insurance costs, high deducible health plans (HDHPs) are becoming more prevalent as a means to prevent overutilization and to control spending. However, there are concerns that despite the well-documented cost effectiveness of preventive services (e.g., hypertension screening, colorectal cancer screening), HDHPs may decrease preventive service utilization. Therefore, the increasing prevalence of HDHPs combined with their potential to reduce uptake of key preventive services merits further investigation.
Objective: The objective of this study is to determine the impact of HDHPs on preventive care use, given the varying types of services in a national sample.
Data & Methods: Deductible level, preventive care utilization, and demographic data from the 2011 and 2012 Medical Expenditure Panel Survey were used. Logistic regression models estimated the odds of having received preventive care service in accordance with US Preventive Service Task Force guidelines based on whether a patient had a low or high deductible health plan.
Results: Logistic regression models showed a significant effect of enrollment in a HDHP on the odds of having had a blood pressure screening within the last year (OR=0.839, 95% CI 0.713 - 0.986), but found no statistically significant effect on the odds of having had a cholesterol screening, routine check-up, flu shot, mammogram, Pap smear, or colonoscopy. Demographic differences are also associated with increased or decreased odds of several preventive services. Women had greater odds than men of having had a blood pressure screening, flu shot, routine checkup, while men had greater odds of having had a colonoscopy. Those with higher income and education generally had high odds of preventive service use. Those with low self-rated health status had greater odds of having had routine check-ups, blood pressure screenings, cholesterol screenings, and flu shots, but had lower odds of having had cancer screenings.
Conclusion: Overall, there is little evidence to suggest that HDHPs are associated with decreased odds of preventive care use. There are, however, demographic characteristics that may drive utilization differences and need to be further explored.
Objective: The objective of this study is to determine the impact of HDHPs on preventive care use, given the varying types of services in a national sample.
Data & Methods: Deductible level, preventive care utilization, and demographic data from the 2011 and 2012 Medical Expenditure Panel Survey were used. Logistic regression models estimated the odds of having received preventive care service in accordance with US Preventive Service Task Force guidelines based on whether a patient had a low or high deductible health plan.
Results: Logistic regression models showed a significant effect of enrollment in a HDHP on the odds of having had a blood pressure screening within the last year (OR=0.839, 95% CI 0.713 - 0.986), but found no statistically significant effect on the odds of having had a cholesterol screening, routine check-up, flu shot, mammogram, Pap smear, or colonoscopy. Demographic differences are also associated with increased or decreased odds of several preventive services. Women had greater odds than men of having had a blood pressure screening, flu shot, routine checkup, while men had greater odds of having had a colonoscopy. Those with higher income and education generally had high odds of preventive service use. Those with low self-rated health status had greater odds of having had routine check-ups, blood pressure screenings, cholesterol screenings, and flu shots, but had lower odds of having had cancer screenings.
Conclusion: Overall, there is little evidence to suggest that HDHPs are associated with decreased odds of preventive care use. There are, however, demographic characteristics that may drive utilization differences and need to be further explored.
Citation
Wright, Daniel. "The Impact of High Deductible Health Plans on Preventive Care Use." Albany College of Pharmacy and Health Sciences, New York, Proquest/UMI, 2015.
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