MPC Member Publications

This database contains a listing of population studies publications written by MPC Members. Anyone can add a publication by an MPC student, faculty, or staff member to this database; new citations will be reviewed and approved by MPC administrators.

Full Citation

Title: The impact of high-deductible health plans on men and women: an analysis of emergency department care

Citation Type: Journal Article

Publication Year: 2013

ISSN: 1537-1948; 0025-7079

DOI: 10.1097/MLR.0b013e31829742d0 [doi]

PMCID: PMC4012427

PMID: 23685403

Abstract: BACKGROUND: Prior studies show that men are more likely than women to defer essential care. Enrollment in high-deductible health plans (HDHPs) could exacerbate this tendency, but sex-specific responses to HDHPs have not been assessed. We measured the impact of an HDHP separately for men and women. METHODS: Controlled longitudinal difference-in-differences analysis of low, intermediate, and high severity emergency department (ED) visits and hospitalizations among 6007 men and 6530 women for 1 year before and up to 2 years after their employers mandated a switch from a traditional health maintenance organization plan to an HDHP, compared with contemporaneous controls (18,433 men and 19,178 women) who remained in an health maintenance organization plan. RESULTS: In the year following transition to an HDHP, men substantially reduced ED visits at all severity levels relative to controls (changes in low, intermediate, and high severity visits of -21.5% [-37.9 to -5.2], -21.6% [-37.4 to -5.7], and -34.4% [-62.1 to -6.7], respectively). Female HDHP members selectively reduced low severity emergency visits (-26.9% [-40.8 to -13.0]) while preserving intermediate and high severity visits. Male HDHP members also experienced a 24.2% [-45.3 to -3.1] relative decline in hospitalizations in year 1, followed by a 30.1% [2.1 to 58.1] relative increase in hospitalizations between years 1 and 2. CONCLUSIONS: Initial across-the-board reductions in ED and hospital care followed by increased hospitalizations imply that men may have foregone needed care following an HDHP transition. Clinicians caring for patients with HDHPs should be aware of sex differences in response to benefit design.

User Submitted?: No

Authors: Kozhimannil, Katy B.; Law, Michael R; Blauer-Peterson, Cori; Zhang, Fuchun; Wharam, J Frank

Periodical (Full): Medical care

Issue: 8

Volume: 51

Pages: 639-1283

Countries:

IPUMS NHGIS NAPP IHIS ATUS Terrapop