Background
Methods
Data
Dependent variables
Explanatory variables
Variable | Total | MOB | DEB | |||
---|---|---|---|---|---|---|
Total | Asian | Black | Hispanic | |||
N | 8,262 (100%) | 6,381 (77.2%) | 1,881 (22.8%) | 92 (1.11%) | 475 (5.75%) | 513 (6.21%) |
Demographic variables
| ||||||
Age (mean) | 69.3 (15.4) | 70.9*** (13.4) | 64.1*** (19.8) | 71.1 (16.0) | 63.5 (20.7) | 67.1 (18.1) |
Elderly (age 65 and over) | 0.80 (0.40) | 0.84*** (0.37) | 0.67*** (0.47) | 0.88 (0.33) | 0.65 (0.48) | 0.77 (0.42) |
Male | 0.41 (0.49) | 0.43*** (0.50) | 0.32*** (0.47) | 0.38 (0.49) | 0.31 (0.48) | 0.33 (0.42) |
Married | 0.41 (0.49) | 0.47*** (0.50) | 0.23*** (0.42) | 0.44 (0.50) | 0.15 (0.36) | 0.31 (0.46) |
Rural | 0.27 (0.45) | 0.26*** (0.44) | 0.30*** (0.46) | 0.04 (0.21) | 0.28 (0.45) | 0.38 (0.39) |
College and more | 0.12 (0.31) | 0.13*** (0.33) | 0.04*** (0.20) | 0.12 (0.33) | 0.03 (0.18) | 0.02 (0.13) |
High school graduation | 0.40 (0.48) | 0.40*** (0.49) | 0.24*** (0.42) | 0.12 (0.33) | 0.25 (0.42) | 0.12 (0.32) |
Less than high school | 0.48 (0.50) | 0.47*** (0.50) | 0.73*** (0.44) | 0.76 (0.43) | 0.74 (0.44) | 0.86 (0.34) |
Asian | 0.02 (0.15) | 0.02*** (0.13) | 0.05*** (0.22) | -- | -- | -- |
Hispanic | 0.17 (0.37) | 0.13*** (0.34) | 0.27*** (0.45) | -- | -- | -- |
Afro-American | 0.18 (0.39) | 0.16*** (0.37) | 0.25*** (0.43) | -- | -- | -- |
Socioeconomic variables
| ||||||
Poverty | 0.25 (0.43) | 0.19*** (0.39) | 0.45*** (0.50) | 0.33 (0.47) | 0.53 (0.50) | 0.38 (0.49) |
Still work | 0.11 (0.31) | 0.13*** (0.34) | 0.04*** (0.20) | 0.02 (0.15) | 0.03 (0.18) | 0.03 (0.17) |
Health-related variables
| ||||||
Poor health | 0.36 (0.48) | 0.32*** (0.47) | 0.50*** (0.50) | 0.36 (0.48) | 0.50 (0.50) | 0.52 (0.50) |
Medical condition(s) of priority list | 0.48 (0.50) | 0.48*** (0.50) | 0.51*** (0.50) | 0.36 (0.50) | 0.58 (0.50) | 0.51 (0.50) |
Number of co-morbidities | 5.67 (4.19) | 5.44*** (4.01) | 6.47*** (4.68) | 4.15 (3.16) | 5.80 (4.45) | 6.40 (4.62) |
Limitation(s) to ADL | 0.11 (0.43) | 0.09*** (0.42) | 0.20*** (0.46) | 0.14 (0.43) | 0.22 (0.47) | 0.22 (0.47) |
Limitation(s) to IADL | 0.19 (0.46) | 0.15*** (0.45) | 0.33*** (0.49) | 0.24 (0.48) | 0.36 (0.50) | 0.30 (0.49) |
Dependent variables
| ||||||
Office-based physician visits | 6.42 (8.26) | 6.09*** (7.44) | 7.54*** (10.52) | 5.98 (17.94) | 6.81 (11.43) | 7.73 (10.05) |
Hospital inpatient nights | 1.95 (7.49) | 1.73*** (7.02) | 2.66*** (8.86) | 0.24 (1.04) | 2.73 (8.31) | 2.80 (9.13) |
Home health provider days | 11.87 (51.4) | 5.82*** (34.0) | 32.5*** (84.7) | 5.04 (27.3) | 40.8 (90.3) | 36.35 (96.9) |
Total dental visits | 0.78 (1.98) | 0.87*** (2.10) | 0.48*** (1.50) | 0.39 (1.00) | 0.45 (1.32) | 0.51 (1.54) |
Statistical analysis
Model 1
Model 2
Specification tests
Health Services | Medicare Beneficiaries | Non-Zero Users |
---|---|---|
Office-based physician visits | 6.418 (100%) | 7.474 (85.88%) |
Hospital inpatient nights | 1.945 (100%) | 10.697 (18.18%) |
Home health provider days | 11.871 (100%) | 103.058 (11.41%) |
Total dental visits | 0.783 (100%) | 2.699 (29.00%) |
Results
Who are dually eligible population?
Office-based physician visits (1) | Hospital inpatient nights (2) | Home health provider days (3) | Total dental visits (4) | |
---|---|---|---|---|
Demographics
| ||||
Age | 0.997 (0.001)*** | 0.997 (0.003) | 1.003 (0.003) | 0.991 (0.002)*** |
Male | 0.993 (0.022) | 1.380 (0.110)*** | 1.097 (0.105) | 0.867 (0.044)*** |
Married | 1.063 (0.023)** | 0.768 (0.062)*** | 0.616 (0.066)*** | 1.178 (0.060)*** |
Less than High School | 0.891 (0.020)*** | 0.979 (0.076) | 0.969 (0.094) | 0.778 (0.054)*** |
Rural | 0.970 (0.023) | 0.984 (0.077) | 1.439 (0.133)*** | 0.759 (0.043)*** |
Region
| ||||
Northeast | 1.083 (0.031)*** | 0.961 (0.100) | 1.242 (0.150)* | 1.357 (0.088)*** |
Midwest | 0.962 (0.027) | 0.974 (0.091) | 0.807 (0.094)* | 1.149 (0.074)** |
West | 0.901 (0.025)*** | 0.715 (0.070)*** | 0.799 (0.100)* | 1.162 (0.075)** |
Medical condition
| ||||
Poor Health | 1.168 (0.026)*** | 1.292 (0.093)*** | 1.424 (0.125)*** | 0.757 (0.042)*** |
Co-morbidities | 1.140 (0.003)*** | 1.060 (0.009)*** | 1.037 (0.010)*** | 1.081 (0.007)*** |
Chronic Disease | 1.147 (0.023)*** | 1.120 (0.079) | 0.850 (0.070)** | 0.909 (0.043)** |
Socioeconomic status
| ||||
Poverty | 1.004 (0.025) | 0.897 (0.074) | 1.020 (0.092) | 0.894 (0.075) |
Still Work | 0.908 (0.032)*** | 0.562 (0.079)*** | 1.602 (0.403)* | 0.833 (0.062)** |
Race & dual eligibility
| ||||
Asian | 0.886 (0.087) | 0.899 (0.458) | 0.044 (0.034)*** | 0.510 (0.117)*** |
Hispanic | 0.997 (0.036) | 1.009 (0.132) | 1.790 (0.313)*** | 1.082 (0.107) |
Afro-American | 0.959 (0.033) | 1.063 (0.130) | 2.216 (0.346)*** | 0.622 (0.072)*** |
Dual Eligibility | 1.016 (0.037) | 1.003 (0.112) | 1.958 (0.234)*** | 0.708 (0.085)*** |
Dual*Asian | 1.235 (0.184) | 0.334 (0.238) | 16.879 (15.54)*** | 1.621 (0.564)* |
Dual*Hispanic | 1.106 (0.067)* | 1.193 (0.237) | 0.943 (0.216) | 1.253 (0.211) |
Dual*Afro-American | 1.170 (0.072)*** | 1.132 (0.226) | 0.643 (0.132)** | 1.926 (0.329)*** |
Inflation model = logit
| ||||
Log likelihood | -22573.77 | -8603.889 | -7757.978 | -8696.873 |
Constant | -4.012 (0.912)*** | 1.480 (0.138)*** | 3.071 (0.201)*** | -3.211 (0.840)*** |
Cancer | -22.16 (16771.5) | -0.500 (0.088)*** | -0.418 (0.088)*** | -0.235 (0.134)* |
Diabetes | -20.73 (7065.7) | -0.518 (0.075)*** | -0.456 (0.078)*** | 0.485 (0.102)*** |
Hypertension | -11.54 (54.42) | -0.158 (0.063)*** | -0.029 (0.072) | 0.043 (0.092) |
Stroke | -1.228 (0.942) | -1.226 (0.129)*** | -1.037 (0.115)*** | 0.404 (0.165)** |
Depression | -1.314 (0.590)** | -0.269 (0.072)*** | -0.352 (0.074)*** | -0.136 (0.100) |
Less than High School | 0.769 (0.235)*** | -0.094 (0.072) | -0.133 (0.081)* | 1.084 (0.138)*** |
Poverty | -0.260 (0.266) | -0.314 (0.096)*** | -0.167 (0.101)* | 0.037 (0.146) |
Still Work | 0.404 (0.321) | 0.084 (0.126) | 0.943 (0.191)*** | -0.742 (0.314)** |
Asian | 0.144 (0.945) | 1.007 (0.340)*** | 1.130 (0.364)*** | -0.391 (0.503) |
Hispanic | 0.130 (0.318) | 0.152 (0.096) | 0.274 (0.106)*** | 0.160 (0.148) |
Afro-American | 0.917 (0.255)*** | 0.321 (0.093)*** | -0.026 (0.096) | 0.030 (0.207) |
Dual eligibility | -1.487 (0.761)* | -0.285 (0.082)*** | -1.066 (0.082)*** | 0.241 (0.145)* |
Income0 | 1.298 (0.987) | 0.300 (0.189) | 0.325 (0.272) | 2.725 (0.813)*** |
Income1 | 1.614 (0.924)* | 0.159 (0.146) | -0.511 (0.214)** | 2.420 (0.795)*** |
Income2 | 1.194 (0.910) | -0.035 (0.136) | -0.620 (0.206)*** | 2.280 (0.790)*** |
Incoem3 | 0.861 (0.949) | 0.211 (0.150) | -0.300 (0.225) | 1.724 (0.780)** |
LR Chi2 (20) | 2,766.11 | 136.25 | 199.10 | 333.40 |
Prob> Chi2 (20) | 0.000 | 0.000 | 0.000 | 0.000 |
Number of obs. | 8,260 | 8,255 | 8,185 | 8,260 |
Nonzero obs. | 7,094 | 1,501 | 942 | 2,395 |
Zero obs. | 1,166 | 6,754 | 7,243 | 5,865 |
alpha | 0.572 (0.014) | 1.906 (0.170) | 1.522 (0.090) | 1.377 (0.119) |
Likelihood-ratio (LR) test of alpha = 0: | Chibar2(01) = 1.7e+04 Prob>=Chibar2 = 0.000 | Chibar2(01) = 1.3e+04; Prob>=Chibar2 = 0.000 | Chibar2(01) = 8.3e+04; Prob>=Chibar2 = 0.000 | Chibar2(01) = 1457.18; Prob>=Chibar2 = 0.000 |
Vuong test of ZINB vs. standard NB: | Z = 5.40; Prob>z = 0.000 | Z = 7.76; Prob>z = 0.000 | Z = 7.95; Prob>z = 0.000 | Z = 8.21; Prob>z = 0.000 |