Biomedical subjects

R Andrew Allison

Publications and source records attributed to R Andrew Allison.

4 recordsLinked to original sources

PubMed2004

Measuring health inequality using qualitative data.

Many questions in health policy require an understanding of the distribution of health status across a given population and how it changes as a result of policy interventions. Since objective data on individual health status are often unavailable or incomplete, especially for populations with very low mortality, increasing use has been made of self-reported health status (SRHS) data, which record people's own perceptions of their health status. SRHS has been shown to be a strong predictor of objective health outcomes and indications, including mortality. Nevertheless, the qualitative or categorical nature of SRHS data prevents the straightforward use of traditional tools of distributional analysis, such as the Lorenz curve, in evaluating inequality. This paper presents a methodology for evaluating inequality when the data are qualitative rather than quantitative in nature. A partial inequality ordering is defined to indicate when a distribution is more "spread out" than another; a second partial ordering (first order dominance) is used to indicate when the overall health level rises. Both are applicable to qualitative data, such as SRHS, in that results do not depend on the numerical scaling assigned to the categories. The approach is illustrated using SRHS data from the National Health Interview Survey (NHIS) State Data Files for 1994, focusing on the distribution of SRHS within states.

Adult↗

PubMed2003

The impact of local welfare offices on children's enrollment in Medicaid and SCHIP.

Nearly 20% of children entering Kansas' State Children's Health Insurance Program (SCHIP) and more than 25% of children entering the state's Medicaid program leave public health insurance altogether before completing a full year of coverage, when the first redetermination of eligibility should occur. Analyses of administrative data indicate that high rates of premature disenrollment are strongly associated with case management practices at local social services offices. However, local offices enroll the vast majority of children into public health insurance. To avoid a potential trade-off between local offices' impact on enrollment and retention, the study suggests that states such as Kansas consider improvements in automation to support caseworkers' difficult jobs.

Aid to Families with Dependent Children↗

PubMed2002

Consequences of states' policies for SCHIP disenrollment.

Policymakers are concerned about disenrollment from the State Children's Health Insurance Program (SCHIP). We describe disenrollment in Florida, Kansas, New York, and Oregon and assess the links between disenrollment and States' SCHIP policies. We found that SCHIP is used on a long-term basis (at least 2 years) for a significant group of new enrollees and as temporary coverage (fewer than 12 months) for many others. Recertification generates large disenrollments (about one-half of children still enrolled at the time), but as many as 25 percent return within 2 months. The increased disenrollment rate at recertification is completely eliminated by a policy of passive re-enrollment.

Adolescent↗

PubMedDate not supplied

SCHIP's impact in three states: how do the most vulnerable children fare?

This study provides consistent evidence, from three very diverse states with heterogeneous populations and distinct programs (Florida, Kansas, and New York), that the State Children's Health Insurance Program (SCHIP) increased access to and satisfaction with health care among enrolled low-income children and that vulnerable children-minorities, children and adolescents with special health care needs, and children who were uninsured for long periods of time-shared in these improvements. We highlight some areas to target for future improvement, such as reducing the high levels of unmet needs among special-needs children and increasing preventive care, especially for Hispanic children.

Adolescent↗