Does Uninsurance Affect the Health Outcomes of the Insured? Evidence from Heart Attack Patients in California

N. Meltem Daysal

Research output: Working paperDiscussion paperOther research output

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Abstract

Abstract: In this paper, I examine the impact of uninsured patients on the health of the insured, focusing on one health outcome - the in-hospital mortality rate of insured heart attack patients. I employ panel data models using patient discharge and hospital financial data from California (1999-2006). My results indicate that uninsured patients have an economically significant effect that increases the mortality rate of insured heart attack patients. I show that these results are not driven by alternative explanations, including reverse causality, patient composition effects, sample selection or unobserved trends and that they are robust to a host of specification checks. My results also indicate that the primary channel for the observed spillover effects is increased hospital uncompensated care costs. Although data limitations constrain my capacity to check how hospitals change their provision of care to insured heart attack patients in response to reduced revenues, the evidence I have suggests a modest increase in the quantity of cardiac services without a corresponding increase in hospital staff.
Original languageEnglish
Place of PublicationTilburg
PublisherEconometrics
Number of pages64
Volume2012-027
Publication statusPublished - 2012

Publication series

NameCentER Discussion Paper
Volume2012-027

Fingerprint

Health outcomes
Attack
Mortality rate
Staff
Causality
Financial data
Sample selection
Revenue
Composition effect
Health
Hospital care
Spillover effects
Costs

Keywords

  • Uninsurance
  • Spillovers
  • Heart Attack Mortality
  • Hospitals

Cite this

Meltem Daysal, N. (2012). Does Uninsurance Affect the Health Outcomes of the Insured? Evidence from Heart Attack Patients in California. (CentER Discussion Paper; Vol. 2012-027). Tilburg: Econometrics.
Meltem Daysal, N. / Does Uninsurance Affect the Health Outcomes of the Insured? Evidence from Heart Attack Patients in California. Tilburg : Econometrics, 2012. (CentER Discussion Paper).
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Meltem Daysal, N 2012 'Does Uninsurance Affect the Health Outcomes of the Insured? Evidence from Heart Attack Patients in California' CentER Discussion Paper, vol. 2012-027, Econometrics, Tilburg.

Does Uninsurance Affect the Health Outcomes of the Insured? Evidence from Heart Attack Patients in California. / Meltem Daysal, N.

Tilburg : Econometrics, 2012. (CentER Discussion Paper; Vol. 2012-027).

Research output: Working paperDiscussion paperOther research output

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AB - Abstract: In this paper, I examine the impact of uninsured patients on the health of the insured, focusing on one health outcome - the in-hospital mortality rate of insured heart attack patients. I employ panel data models using patient discharge and hospital financial data from California (1999-2006). My results indicate that uninsured patients have an economically significant effect that increases the mortality rate of insured heart attack patients. I show that these results are not driven by alternative explanations, including reverse causality, patient composition effects, sample selection or unobserved trends and that they are robust to a host of specification checks. My results also indicate that the primary channel for the observed spillover effects is increased hospital uncompensated care costs. Although data limitations constrain my capacity to check how hospitals change their provision of care to insured heart attack patients in response to reduced revenues, the evidence I have suggests a modest increase in the quantity of cardiac services without a corresponding increase in hospital staff.

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Meltem Daysal N. Does Uninsurance Affect the Health Outcomes of the Insured? Evidence from Heart Attack Patients in California. Tilburg: Econometrics. 2012. (CentER Discussion Paper).