Oregon Health Insurance Experiment, 2007-2010

Résumé 0

In 2008, a group of uninsured low-income adults in Oregon was selected by lottery to be given the chance to apply for Medicaid. This lottery provides an opportunity to gauge the effects of expanding access to public health insurance on the health care use, financial strain, and health of low-income adults using a randomized controlled design. The Oregon Health Insurance Experiment follows and compares those selected in the lottery (treatment group) with those not selected (control group). The data collected and provided here include data from in-person interviews, three mail surveys, emergency department records, and administrative records on Medicaid enrollment, the initial lottery sign-up list, welfare benefits, and mortality. This data collection has seven data files: Dataset 1 contains administrative data on the lottery from the state of Oregon. These data include demographic characteristics that were recorded when individuals signed up for the lottery, date of lottery draw, and information on who was selected for the lottery, applied for the lotteried Medicaid plan if selected, and whose application for the lotteried plan was approved. Also included are Oregon mortality data for 2008 and 2009. Dataset 2 contains information from the state of Oregon on the individuals' participation in Medicaid, Supplemental Nutrition Assistance Program (SNAP), and Temporary Assistance to Needy Families (TANF). Datasets 3-5 contain the data from the initial, six month, and 12 month mail surveys, respectively. Topics covered by the surveys include demographic characteristics; health insurance, access to health care and health care utilization; health care needs, experiences, and costs; overall health status and changes in health; and depression and medical conditions and use of medications to treat them. Dataset 6 contains an analysis subset of the variables from the in-person interviews. Topics covered by the survey questionnaire include overall health, health insurance coverage, health care access, health care utilization, conditions and treatments, health behaviors, medical and dental costs, and demographic characteristics. The interviewers also obtained blood pressure and anthropometric measurements and collected dried blood spots to measure levels of cholesterol, glycated hemoglobin and C-reactive protein. Dataset 7 contains an analysis subset of the variables the study obtained for all emergency department (ED) visits to twelve hospitals in the Portland area during 2007-2009. These variables capture total hospital costs, ED costs, and the number of ED visits categorized by time of the visit (daytime weekday or nighttime and weekends), necessity of the visit (emergent, ED care needed, non-preventable; emergent, ED care needed, preventable; emergent, primary care treatable), ambulatory case sensitive status, whether or not the patient was hospitalized, and the reason for the visit (e.g., injury, abdominal pain, chest pain, headache, and mental disorders). The collection also includes a ZIP archive (Dataset 8) with Stata programs that replicate analyses reported in three articles by the principal investigators and others: Finkelstein, Amy et al "The Oregon Health Insurance Experiment: Evidence from the First Year". The Quarterly Journal of Economics. August 2012. Vol 127(3). Baicker, Katherine et al "The Oregon Experiment - Effects of Medicaid on Clinical Outcomes". New England Journal of Medicine. 2 May 2013. Vol 368(18). Taubman, Sarah et al "Medicaid Increases Emergency Department Use: Evidence from Oregon's Health Insurance Experiment". Science. 2 Jan 2014.