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Type of health insurance and the quality of primary care experience

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  • Shi, L.

Abstract

Objectives. This study examined the association between type of health insurance coverage and quality of primary care as measured by its distinguishing attributes - first contact, longitudinality, comprehensiveness, and coordination. Methods. The household component of the 1996 Medical Expenditure Panel Survey was used for this study. The analysis primarily focused on subjects aged younger than 65 years who identified a usual source of care. Logistic regressions were used to examine the independent effects of insurance status on primary care attributes while individual sociodemographic characteristics were controlled for. Results. The experience of primary care varies according to insurance status. The insured are able to obtain better primary care than the uninsured, and the privately insured are able to obtain better primary care than the publicly insured. Those insured through fee-for-service coverage experience better longitudinal care and less of a barrier to access than those insured through health maintenance organizations (HMOs). Conclusions. While expanding insurance coverage is important for establishing access to care, efforts are needed to enhance the quality of primary health care, particularly for the publicly insured. Policymakers should closely monitor the quality of primary care provided by HMOs.

Suggested Citation

  • Shi, L., 2000. "Type of health insurance and the quality of primary care experience," American Journal of Public Health, American Public Health Association, vol. 90(12), pages 1848-1855.
  • Handle: RePEc:aph:ajpbhl:2000:90:12:1848-1855_4
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    Cited by:

    1. Testa, Alexander & Jackson, Dylan B. & Vaughn, Michael G. & Ganson, Kyle T. & Nagata, Jason M., 2022. "Adverse Childhood Experiences, health insurance status, and health care utilization in middle adulthood," Social Science & Medicine, Elsevier, vol. 314(C).
    2. Magdalena MuszyƱska & Roland Rau Roland, 2014. "Did Men Benefit More from Medical Progress in Recent Decades? Cause-of-Death Contributions to the Decreasing Sex-Gap in Life Expectancy in the United States," Working Papers 72, Institute of Statistics and Demography, Warsaw School of Economics.
    3. James Kirby & Toshiko Kaneda, 2010. "Unhealthy and uninsured: Exploring racial differences in health and health insurance coverage using a life table approach," Demography, Springer;Population Association of America (PAA), vol. 47(4), pages 1035-1051, November.

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