Urban Institute

About: Urban Institute is a nonprofit organization based out in Washington D.C., District of Columbia, United States. It is known for research contribution in the topics: Medicaid & Population. The organization has 927 authors who have published 2330 publications receiving 86426 citations.

On The Road To Universal Coverage: Impacts Of Reform In Massachusetts At One Year

Abstract: In April 2006, Massachusetts passed legislation intended to move the state to near-universal coverage within three years and, in conjunction with that expansion, to improve access to affordable, high-quality health care. In roughly the first year under reform, uninsurance among working-age adults was reduced by almost half among those surveyed, dropping from 13 percent in fall 2006 to 7 percent in fall 2007. At the same time, access to care improved, and the share of adults with high out-of-pocket costs and problems paying medical bills dropped. Despite higher-than-anticipated costs, most residents of the state continued to support reform.

How much medical care do the uninsured use, and who pays for it?

Abstract: With the number of uninsured exceeding 41 million people in 2001, insuring the uninsured is again a major policy issue. This analysis establishes benchmarks for the inevitable debate over the cost of expanding coverage: how much is currently spent on care for the uninsured and where does the money come from? This information is essential for assessing how much new money will be required for expanded coverage, how much can be reallocated from existing sources, and how a new financing system would redistribute the burden of subsidizing care for the uninsured from private to public sources (Health Affairs,/i> Web Exclusive, February 2003).

Events that Trigger Poverty Entries and Exits

Abstract: Objective. This article examines how events—such as changes in household composition, employment status, disability status, and economic conditions—affect poverty entries and exits. We also examine whether the role these events play in poverty transitions differs in the pre- and post-welfare-reform periods. Methods. The analysis uses discrete-time multivariate hazard models along with monthly, longitudinal data from the 1988, 1990, and 1996 panels of the Survey of Income and Program Participation (SIPP). Results. Analyses show that many events are related to the likelihood of entering and exiting poverty. Of the trigger events examined, individuals living in households that experience a loss or gain of employment are the most likely to enter and exit poverty. We also find that changes in employment are more important in the 1996 to 1999 time period—after welfare reform—than in the 1988 to 1992 time period—prior to welfare reform. Finally, changes in household composition, disability status, and educational attainment are found to play a role in throwing people into poverty and helping them exit from poverty in both time periods. Conclusions. There is no single path into or out of poverty, suggesting that multiple policies can be considered to help alleviate poverty. The U.S. poverty rate fell from over 15 percent in 1993—one of its highest levels in three decades, to 11.3 percent in 2000—its lowest level in two decades. 1 But even at this low, one in 10 people were in poverty,

Health Services Research and Data Linkages: Issues, Methods, and Directions for the Future

Abstract: Research on pressing health services and policy issues requires access to complete, accurate, and timely patient and organizational data. However, in the United States, health-related datasets are created and held by diverse—often unrelated—public and private organizations and individual researchers. To overcome incomplete data from a single source, skilled researchers take months or years to acquire, link, and extract meaningful information from a myriad of secondary datasets. Through data linkage it is possible to get more complete information without the time and cost burden of additional and often duplicate primary data collection. Typical core datasets that are often linked and the information they contain are described in Table 1. Table 1 Commonly Linked Databases We provide an overview of commonly linked files and describe a generic process for linking datasets. We categorize the major agents (i.e., who owns and controls data and who carries out the data linkage) into three areas: (1) individual investigators, (2) government-sponsored linked databases, and (3) public–private partnerships that facilitate use and linkage of data owned and controlled by private organizations. These different agents shape whether and how readily disparate datasets can be accessed, linked, and mined by researchers. We also describe challenges that may be encountered in the linkage process, and the benefits of combining secondary databases with primary qualitative and quantitative sources. Throughout the paper, we use cancer care research to illustrate our points. Cancer provides an excellent example because of its high prevalence and societal burden. As a result, several publicly and privately sponsored efforts have collaborated to create a data infrastructure that extends beyond traditional data systems. We conclude with recommendations to strengthen the existing data infrastructure. New strategies are needed to develop more accessible and comprehensive data systems to support the next generation of health services and policy research, including comparative effectiveness research.

Sexual activity and contraceptive practices among teenagers in the United States, 1988 and 1995.

Abstract: This report presents national estimates of sexual activity and contraception among teenagers aged 15-19 years in the US Information are presented for the years 1988 and 1995 according to age race and other important demographic and social factors Descriptive tables of numbers and percents are presented and interpreted Data for females are from the National Survey of Family Growth and data for males are from the National Survey of Adolescent Males Highlighted are the results on sexual experience and activity contraceptive use and other aspects of sexual behavior About 175 million teenagers had sexual intercourse at least once in 1995 with 29% of females and 19% of males having unprotected recent sexual intercourse The condom remained the most popular method of contraception These results show that between 1988 and 1995 the overall level of teenagers sexual risk-taking appears to have declined These shifts in sexual and contraceptive behavior help explain declines over the past decade in teenage pregnancy and birth rates However not all teenagers have participated in the movement towards less risk-taking and long-standing racial differences persist These suggest the need to give special attention to the groups of teenagers who are lagging behind their peers