Obesity Discussion Forums - View Single Post - Use of Health Care Services by Lower-Income and Higher-Income Uninsured Adults

Obesity Discussion · 05-20-06, 02:56 PM

Corresponding Author: Joseph S. Ross, MD, Robert Wood Johnson Clinical Scholars Program, Yale University School of Medicine, 333 Cedar St, Room IE-61 SHM, PO Box 208088, New Haven, CT 06520-8088 (joseph.s.ross@yale.edu).

Author Contributions: Drs Ross and Busch had full access to all of the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis.

Study concept and design: Ross, Busch.

Acquisition of data: Ross.

Analysis and interpretation of data: Ross, Bradley, Busch.

Drafting of the manuscript: Ross.

Critical revision of the manuscript for important intellectual content: Ross, Bradley, Busch.

Statistical analysis: Ross, Busch.

Administrative, technical, or material support: Busch.

Study supervision: Busch.

Financial Disclosures: None reported.

Funding/Support: No external funding was used for this research project. Dr Ross is a scholar in the Robert Wood Johnson Clinical Scholars Program at Yale University, sponsored by the Robert Wood Johnson Foundation.

Role of the Sponsor: The Robert Wood Johnson Foundation had no role in the design or conduct of the study; collection, management, analysis, or interpretation of the data; or preparation, review, or approval of the manuscript.

Previous Presentation: The cancer prevention service analyses were presented at the Academy Health 2005 Annual Research Meeting; June 26, 2005; Boston, Mass.

Author Affiliations: Robert Wood Johnson Clinical Scholars Program, Department of Internal Medicine, School of Medicine (Dr Ross), and Division of Health Policy and Administration, School of Epidemiology and Public Health (Drs Bradley and Busch), Yale University, New Haven, Conn.

1. Holahan J, Cook A. Changes in economic conditions and health insurance coverage, 2000-2004. Health Aff (Millwood). Nov 1, 2005:W5-498-W5-508. FREE FULL TEXT
2. Institute of Medicine. Insuring America's Health: Principles and Recommendations. Washington, DC: National Academy Press; 2004.
3. Ayanian JZ, Weissman JS, Schneider EC, Ginsburg JA, Zaslavsky AM. Unmet health needs of uninsured adults in the United States. JAMA. 2000;284:2061-2069. FREE FULL TEXT
4. Breen N, Wagener DK, Brown ML, Davis WW, Ballard-Barbash R. Progress in cancer screening over a decade: results of cancer screening from the 1987, 1992, and 1998 National Health Interview Surveys. J Natl Cancer Inst. 2001;93:1704-1713. FREE FULL TEXT
5. Powell-Griner E, Bolen J, Bland S. Health care coverage and use of preventive services among the near elderly in the United States. Am J Public Health. 1999;89:882-886. ABSTRACT
6. DeVoe JE, Fryer GE, Phillips R, Green L. Receipt of preventive care among adults: insurance status and usual source of care. Am J Public Health. 2003;93:786-791. FREE FULL TEXT
7. Beckles GL, Engelgau MM, Narayan KM, Herman WH, Aubert RE, Williamson DF. Population-based assessment of the level of care among adults with diabetes in the U.S. Diabetes Care. 1998;21:1432-1438. ABSTRACT
8. McWilliams JM, Zaslavsky AM, Meara E, Ayanian JZ. Impact of Medicare coverage on basic clinical services for previously uninsured adults. JAMA. 2003;290:757-764. FREE FULL TEXT
9. Shi L, Stevens GD. Vulnerability and unmet health care needs: the influence of multiple risk factors. J Gen Intern Med. 2005;20:148-154. FULL TEXT | PUBMED
10. Collins SR, Davis K, Doty MM, Ho A. Wages, Health Benefits, and Workers' Health. New York, NY: The Commonwealth Fund; 2004.
11. Saver BG, Peterfreund N. Insurance, income, and access to ambulatory care in King County, Washington. Am J Public Health. 1993;83:1583-1588. ABSTRACT
12. Newhouse JP. Free For All? Lessons From the RAND Health Insurance Experiment. Cambridge, Mass: Harvard University Press; 1996.
13. Robinson JC. Health savings accounts–the ownership society in health care. N Engl J Med. 2005;353:1199-1202. FREE FULL TEXT
14. Centers for Disease Control and Prevention Web site. Data quality report: Behavioral Risk Factor Surveillance System. Available at: http://www.cdc.gov/brfss/technical_i...lityReport.pdf. Accessed January 23, 2006.
15. Centers for Disease Control and Prevention Web site. Survey overview: Behavioral Risk Factor Surveillance System. Available at: http://www.cdc.gov/brfss/technical_i...verview_02.rtf. Accessed January 23, 2006.
16. Centers for Disease Control and Prevention Web site. Questionnaires: Behavioral Risk Factor Surveillance System. Available at: http://www.cdc.gov/brfss/questionnai.../2002brfss.pdf. Accessed January 23, 2006.
17. United States Preventive Services Task Force. Agency for Healthcare Research and Quality Web Site. Screening for cervical cancer. Available at: http://www.ahrq.gov/clinic/uspstf/uspscerv.htm. Accessed January 23, 2006.
18. United States Preventive Services Task Force. Agency for Healthcare Research and Quality Web site. Screening for breast cancer. Available at: http://www.ahrq.gov/clinic/uspstf/uspsbrca.htm. Accessed January 23, 2006.
19. United States Preventive Services Task Force. Agency for Healthcare Research and Quality Web site. Screening for colorectal cancer. Available at: http://www.ahrq.gov/clinic/uspstf/uspscolo.htm. Accessed January 23, 2006.
20. United States Preventive Services Task Force. Agency for Healthcare Research and Quality Web site. Screening for lipid disorders in adults. Available at: http://www.ahrq.gov/clinic/uspstf/uspschol.htm. Accessed January 23, 2006.
21. AACE medical guidelines for clinical practice for the diagnosis and treatment of dyslipidemia and prevention of atherogenesis. Endocr Pract. 2000;6:162-213. PUBMED
22. Antman EM, Anbe DT, Armstrong PW, et al. ACC/AHA guidelines for the management of patients with ST-elevation myocardial infarction: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee to Revise the 1999 Guidelines for the Management of Patients With Acute Myocardial Infarction). J Am Coll Cardiol. 2004;44:E1-E211. FULL TEXT | PUBMED
23. Albers GW, Amarenco P, Easton JD, Sacco RL, Teal P. Antithrombotic and thrombolytic therapy for ischemic stroke: the Seventh ACCP Conference on Antithrombotic and Thrombolytic Therapy. Chest. 2004;126(3 suppl):483S-512S. FREE FULL TEXT
24. United States Preventive Services Task Force. Agency for Healthcare Research and Quality Web site. Counseling: tobacco use. Available at: http://www.ahrq.gov/clinic/uspstf/uspstbac.htm. Accessed January 23, 2006.
25. United States Preventive Services Task Force. Agency for Healthcare Research and Quality Web site. Screening for obesity in adults. Available at: http://www.ahrq.gov/clinic/uspstf/uspsobes.htm. Accessed January 23, 2006.
26. Standards of medical care in diabetes. Diabetes Care. 2004;27(suppl 1):S15-S35. FREE FULL TEXT
27. Poverty income guidelines; annual update. Federal Register. 2002;67:6931-6933.
28. Little RJA. Direct standardization: a tool for teaching linear models for unbalanced data. Am Stat. 1982;36:38-43. ISI
29. Leape LL, Hilborne LH, Bell R, Kamberg C, Brook RH. Underuse of cardiac procedures: do women, ethnic minorities, and the uninsured fail to receive needed revascularization? Ann Intern Med. 1999;130:183-192. FREE FULL TEXT
30. Frane J. SUDAAN: Professional Software for Survival Data Analysis. Research Triangle Park, NC: Research Triangle Institute; 1989.
31. LaVange LM, Stearns SC, Lafata JE, Koch GG, Shah BV. Innovative strategies using SUDAAN for analysis of health surveys with complex samples. Stat Methods Med Res. 1996;5:311-329. PUBMED
32. Blendon RJ, Young JT, DesRoches CM. The uninsured, the working uninsured, and the public. Health Aff (Millwood). 1999;18:203-211. FREE FULL TEXT
33. Healthy People 2010 Web site. About Healthy People. Available at: http://www.healthypeople.gov/About/. Accessed January 9, 2006.
34. Cooper PF, Schone BS. More offers, fewer takers for employment-based health insurance: 1987 and 1996. Health Aff (Millwood). 1997;16:142-149. FREE FULL TEXT
35. Brown JB, Adams ME. Patients as reliable reporters of medical care process: recall of ambulatory encounter events. Med Care. 1992;30:400-411. ISI | PUBMED
36. Newell SA, Girgis A, Sanson-Fisher RW, Savolainen NJ. The accuracy of self-reported health behaviors and risk factors relating to cancer and cardiovascular disease in the general population: a critical review. Am J Prev Med. 1999;17:211-229. FULL TEXT | ISI | PUBMED
37. Johnson TP, O'Rourke DP, Burris JE, Warnecke RB. An investigation of the effects of social desirability on the validity of self-reports of cancer screening behaviors. Med Care. 2005;43:565-573. FULL TEXT | ISI | PUBMED
38. Centers for Disease Control and Prevention. Behavioral Risk Factor Surveillance System Web site. Technical documents and survey data. Available at: http://www.cdc.gov/brfss/technical_i...surveydata.htm. Accessed January 23, 2006.
39. Turrell G. Income non-reporting: implications for health inequalities research. J Epidemiol Community Health. 2000;54:207-214. FREE FULL TEXT
40. Sudano JJ Jr, Baker DW. Intermittent lack of health insurance coverage and use of preventive services. Am J Public Health. 2003;93:130-137. FREE FULL TEXT

05-20-06, 02:56 PM	#3 (permalink)
Obesity Discussion Administrator Join Date: Jan 2005 Location: Phoenix, AZ Posts: 7,851 Weight Statistics 8/1/2006 Start Date: 185 lb Start Weight: 152 lb Current Weight: 155 lb Goal Weight: -33 lb Weight Loss: 5/1/2007 Goal Date:	Re: Use of Health Care Services by Lower-Income and Higher-Income Uninsured Adults Corresponding Author: Joseph S. Ross, MD, Robert Wood Johnson Clinical Scholars Program, Yale University School of Medicine, 333 Cedar St, Room IE-61 SHM, PO Box 208088, New Haven, CT 06520-8088 (joseph.s.ross@yale.edu). Author Contributions: Drs Ross and Busch had full access to all of the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis. Study concept and design: Ross, Busch. Acquisition of data: Ross. Analysis and interpretation of data: Ross, Bradley, Busch. Drafting of the manuscript: Ross. Critical revision of the manuscript for important intellectual content: Ross, Bradley, Busch. Statistical analysis: Ross, Busch. Administrative, technical, or material support: Busch. Study supervision: Busch. Financial Disclosures: None reported. Funding/Support: No external funding was used for this research project. Dr Ross is a scholar in the Robert Wood Johnson Clinical Scholars Program at Yale University, sponsored by the Robert Wood Johnson Foundation. Role of the Sponsor: The Robert Wood Johnson Foundation had no role in the design or conduct of the study; collection, management, analysis, or interpretation of the data; or preparation, review, or approval of the manuscript. Previous Presentation: The cancer prevention service analyses were presented at the Academy Health 2005 Annual Research Meeting; June 26, 2005; Boston, Mass. Author Affiliations: Robert Wood Johnson Clinical Scholars Program, Department of Internal Medicine, School of Medicine (Dr Ross), and Division of Health Policy and Administration, School of Epidemiology and Public Health (Drs Bradley and Busch), Yale University, New Haven, Conn. 1. Holahan J, Cook A. Changes in economic conditions and health insurance coverage, 2000-2004. Health Aff (Millwood). Nov 1, 2005:W5-498-W5-508. FREE FULL TEXT 2. Institute of Medicine. Insuring America's Health: Principles and Recommendations. Washington, DC: National Academy Press; 2004. 3. Ayanian JZ, Weissman JS, Schneider EC, Ginsburg JA, Zaslavsky AM. Unmet health needs of uninsured adults in the United States. JAMA. 2000;284:2061-2069. FREE FULL TEXT 4. Breen N, Wagener DK, Brown ML, Davis WW, Ballard-Barbash R. Progress in cancer screening over a decade: results of cancer screening from the 1987, 1992, and 1998 National Health Interview Surveys. J Natl Cancer Inst. 2001;93:1704-1713. FREE FULL TEXT 5. Powell-Griner E, Bolen J, Bland S. Health care coverage and use of preventive services among the near elderly in the United States. Am J Public Health. 1999;89:882-886. ABSTRACT 6. DeVoe JE, Fryer GE, Phillips R, Green L. Receipt of preventive care among adults: insurance status and usual source of care. Am J Public Health. 2003;93:786-791. FREE FULL TEXT 7. Beckles GL, Engelgau MM, Narayan KM, Herman WH, Aubert RE, Williamson DF. Population-based assessment of the level of care among adults with diabetes in the U.S. Diabetes Care. 1998;21:1432-1438. ABSTRACT 8. McWilliams JM, Zaslavsky AM, Meara E, Ayanian JZ. Impact of Medicare coverage on basic clinical services for previously uninsured adults. JAMA. 2003;290:757-764. FREE FULL TEXT 9. Shi L, Stevens GD. Vulnerability and unmet health care needs: the influence of multiple risk factors. J Gen Intern Med. 2005;20:148-154. FULL TEXT \| PUBMED 10. Collins SR, Davis K, Doty MM, Ho A. Wages, Health Benefits, and Workers' Health. New York, NY: The Commonwealth Fund; 2004. 11. Saver BG, Peterfreund N. Insurance, income, and access to ambulatory care in King County, Washington. Am J Public Health. 1993;83:1583-1588. ABSTRACT 12. Newhouse JP. Free For All? Lessons From the RAND Health Insurance Experiment. Cambridge, Mass: Harvard University Press; 1996. 13. Robinson JC. Health savings accounts–the ownership society in health care. N Engl J Med. 2005;353:1199-1202. FREE FULL TEXT 14. Centers for Disease Control and Prevention Web site. Data quality report: Behavioral Risk Factor Surveillance System. Available at: http://www.cdc.gov/brfss/technical_i...lityReport.pdf. Accessed January 23, 2006. 15. Centers for Disease Control and Prevention Web site. Survey overview: Behavioral Risk Factor Surveillance System. Available at: http://www.cdc.gov/brfss/technical_i...verview_02.rtf. Accessed January 23, 2006. 16. Centers for Disease Control and Prevention Web site. Questionnaires: Behavioral Risk Factor Surveillance System. Available at: http://www.cdc.gov/brfss/questionnai.../2002brfss.pdf. Accessed January 23, 2006. 17. United States Preventive Services Task Force. Agency for Healthcare Research and Quality Web Site. Screening for cervical cancer. Available at: http://www.ahrq.gov/clinic/uspstf/uspscerv.htm. Accessed January 23, 2006. 18. United States Preventive Services Task Force. Agency for Healthcare Research and Quality Web site. Screening for breast cancer. Available at: http://www.ahrq.gov/clinic/uspstf/uspsbrca.htm. Accessed January 23, 2006. 19. United States Preventive Services Task Force. Agency for Healthcare Research and Quality Web site. Screening for colorectal cancer. Available at: http://www.ahrq.gov/clinic/uspstf/uspscolo.htm. Accessed January 23, 2006. 20. United States Preventive Services Task Force. Agency for Healthcare Research and Quality Web site. Screening for lipid disorders in adults. Available at: http://www.ahrq.gov/clinic/uspstf/uspschol.htm. Accessed January 23, 2006. 21. AACE medical guidelines for clinical practice for the diagnosis and treatment of dyslipidemia and prevention of atherogenesis. Endocr Pract. 2000;6:162-213. PUBMED 22. Antman EM, Anbe DT, Armstrong PW, et al. ACC/AHA guidelines for the management of patients with ST-elevation myocardial infarction: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee to Revise the 1999 Guidelines for the Management of Patients With Acute Myocardial Infarction). J Am Coll Cardiol. 2004;44:E1-E211. FULL TEXT \| PUBMED 23. Albers GW, Amarenco P, Easton JD, Sacco RL, Teal P. Antithrombotic and thrombolytic therapy for ischemic stroke: the Seventh ACCP Conference on Antithrombotic and Thrombolytic Therapy. Chest. 2004;126(3 suppl):483S-512S. FREE FULL TEXT 24. United States Preventive Services Task Force. Agency for Healthcare Research and Quality Web site. Counseling: tobacco use. Available at: http://www.ahrq.gov/clinic/uspstf/uspstbac.htm. Accessed January 23, 2006. 25. United States Preventive Services Task Force. Agency for Healthcare Research and Quality Web site. Screening for obesity in adults. Available at: http://www.ahrq.gov/clinic/uspstf/uspsobes.htm. Accessed January 23, 2006. 26. Standards of medical care in diabetes. Diabetes Care. 2004;27(suppl 1):S15-S35. FREE FULL TEXT 27. Poverty income guidelines; annual update. Federal Register. 2002;67:6931-6933. 28. Little RJA. Direct standardization: a tool for teaching linear models for unbalanced data. Am Stat. 1982;36:38-43. ISI 29. Leape LL, Hilborne LH, Bell R, Kamberg C, Brook RH. Underuse of cardiac procedures: do women, ethnic minorities, and the uninsured fail to receive needed revascularization? Ann Intern Med. 1999;130:183-192. FREE FULL TEXT 30. Frane J. SUDAAN: Professional Software for Survival Data Analysis. Research Triangle Park, NC: Research Triangle Institute; 1989. 31. LaVange LM, Stearns SC, Lafata JE, Koch GG, Shah BV. Innovative strategies using SUDAAN for analysis of health surveys with complex samples. Stat Methods Med Res. 1996;5:311-329. PUBMED 32. Blendon RJ, Young JT, DesRoches CM. The uninsured, the working uninsured, and the public. Health Aff (Millwood). 1999;18:203-211. FREE FULL TEXT 33. Healthy People 2010 Web site. About Healthy People. Available at: http://www.healthypeople.gov/About/. Accessed January 9, 2006. 34. Cooper PF, Schone BS. More offers, fewer takers for employment-based health insurance: 1987 and 1996. Health Aff (Millwood). 1997;16:142-149. FREE FULL TEXT 35. Brown JB, Adams ME. Patients as reliable reporters of medical care process: recall of ambulatory encounter events. Med Care. 1992;30:400-411. ISI \| PUBMED 36. Newell SA, Girgis A, Sanson-Fisher RW, Savolainen NJ. The accuracy of self-reported health behaviors and risk factors relating to cancer and cardiovascular disease in the general population: a critical review. Am J Prev Med. 1999;17:211-229. FULL TEXT \| ISI \| PUBMED 37. Johnson TP, O'Rourke DP, Burris JE, Warnecke RB. An investigation of the effects of social desirability on the validity of self-reports of cancer screening behaviors. Med Care. 2005;43:565-573. FULL TEXT \| ISI \| PUBMED 38. Centers for Disease Control and Prevention. Behavioral Risk Factor Surveillance System Web site. Technical documents and survey data. Available at: http://www.cdc.gov/brfss/technical_i...surveydata.htm. Accessed January 23, 2006. 39. Turrell G. Income non-reporting: implications for health inequalities research. J Epidemiol Community Health. 2000;54:207-214. FREE FULL TEXT 40. Sudano JJ Jr, Baker DW. Intermittent lack of health insurance coverage and use of preventive services. Am J Public Health. 2003;93:130-137. FREE FULL TEXT __________________