Health Insurance, Labor Supply, and Health

健康保险、劳动力供应和健康

基本信息

批准号：
7251762
负责人：
Cathy J Bradley
金额：
$ 43.18万
依托单位：
VIRGINIA COMMONWEALTH UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2007
资助国家：
美国
起止时间：
2007-05-01 至 2012-03-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/7251762
关键词：
Address Adherence Adoption Adult Affect Age American American Cancer Society Behavior Behavioral Breast Cancer Burden Cancer Patient Caring Cobra Condition Convalescence Data Data Analyses Data Set Decision Making Dependence Diagnosis Diagnostic Neoplasm Staging Dimensions Disease Dose Elderly Employee Employment Employment Status Experimental Designs Failure Family Family member Foundations Frequencies Hand Health Health Care Costs Health Insurance Health Policy Health Status Healthcare Hour In Situ Incentives Individual Insurance Insurance Coverage Interruption Intuition Invasive Investigation Knowledge Laws Maintenance Malignant Neoplasms Marketing Massachusetts Mastectomy Medical Records Newly Diagnosed Numbers Occupations Operative Surgical Procedures Outcome Parents Patient Care Patients Physicians Policies Population Study Principal Investigator Publishing Questionnaires Radiation Recording of previous events Recovery Relative (related person)Reporting Research Research Design Research Personnel SF-36 Science Scientific Advances and Accomplishments Shock Source Spouses Stage at Diagnosis Statutes and Laws Taste Perception Time Treatment Protocols Uninsured United States Woman Work World War II abstracting base breast cancer diagnosis breast lumpectomy cancer recurrence cancer therapy caregiving chemotherapy cost expectation experience improved innovation malignant breast neoplasm mortality programs research study response satisfaction

项目摘要

DESCRIPTION (provided by applicant): Our proposed research uses a quasi-experimental design to estimate how treatment adherence, health outcomes, and labor supply respond to whether or not an individual's insurance is provided by their own employer. Because many women obtain health insurance through their spouse's employment, while many others obtain it through their own employment, the labor supply response of women to illness-and how that response depends on the source of the health insurance-provides a natural context for addressing our research questions. Thus, we chose employed, married women newly diagnosed with breast cancer and their spouses as subjects for an investigation into the relationship between ECHI, health, and labor supply. Our aims are: 1) To compare treatment and treatment adherence between women with employment- contingent health insurance and women with health insurance through their spouse. Suggestive evidence from our prior study indicated that women with ECHI may forego treatment (e.g., doses of radiation, courses of chemotherapy) to avoid interruptions in their ability to meet work demands. To formally investigate this, we propose to abstract treatment and treatment adherence data from medical records. We will then examine the relationship between treatment and treatment adherence based on source of health insurance. Treatment and treatment adherence may be indicative of long-term health outcomes such as cancer recurrence and mortality. 2) To compare changes in health status between women with employment- contingent health insurance and women with health insurance through their spouse. One of the most important aspects of our research is how policies such as ECHI ultimately affect health status. We will examine health status by obtaining women's responses to questionnaires (specifically, the SF-36 and the Functional Assessment of Cancer Therapy-Breast (FACT-B)) at 2, 6, and 12 months following diagnosis. 3) To compare labor supply responses to cancer between women with employment-contingent health insurance and women with health insurance through their spouse. We propose to collect data with which to compare the effects of breast cancer on the labor supply of employed married women 2, 6, and 12 months following diagnosis, relative to their labor supply at the time immediately preceding their diagnosis. 4) To examine the labor supply responses of spouses following their partner's breast cancer diagnosis. Conceivably, ECHI creates similar labor supply incentives for employed, healthy spouses of women with breast cancer as it does for women with the disease. Spouses with ECHI may maintain high labor supply and hence forego care giving activities so that they can preserve their ECHI. To our knowledge, this integral way of addressing the incentives and pitfalls of ECHI has not been previously examined.

描述（由申请人提供）：我们拟议的研究使用准实验设计来估计如何应对个人的保险是否由自己的雇主提供。由于许多妇女通过配偶的就业获得健康保险，而许多其他妇女通过自己的工作获得了健康保险，因此妇女对疾病的劳动力供应反应以及该反应如何取决于提供健康保险的来源是解决我们的研究问题的自然背景。因此，我们选择了新诊断为乳腺癌及其配偶的已婚妇女作为对ECHI，健康和劳动力供应之间关系进行调查的对象。我们的目的是：1）比较妇女与雇佣保险保险的妇女与通过配偶获得健康保险的妇女之间的治疗和治疗依从性。我们先前研究的暗示性证据表明，ECHI的女性可能会放弃治疗（例如，放射剂量，化学疗法课程），以避免中断她们满足工作需求的能力。为了正式研究这一点，我们建议从医疗记录中抽象治疗和治疗依从性数据。然后，我们将根据健康保险来源研究治疗和治疗依从性之间的关系。治疗和治疗依从性可能表明了长期健康结果，例如癌症复发和死亡率。 2）比较妇女与雇佣保险的妇女之间的健康状况变化与通过其配偶具有健康保险的妇女进行比较。我们研究最重要的方面之一是ECHI等政策最终如何影响健康状况。我们将通过在诊断后2、6和12个月的时间获得妇女对问卷的回答（特别是SF-36和癌症治疗胸部（FACT-B））来检查健康状况。 3）比较具有劳动生健康保险的妇女与通过其配偶拥有健康保险的妇女之间对癌症的劳动供应反应。我们建议收集数据，以比较诊断后乳腺癌对已婚妇女2、6和12个月的劳动供应的影响，相对于其诊断之前的劳动力供应。 4）检查伴侣乳腺癌诊断后配偶的劳动供应反应。可以想象，ECHI为受雇的健康配偶的乳腺癌女性与对患有疾病的女性一样，为劳动力供应激励措施类似。具有ECHI的配偶可以维持高劳动力供应，因此放弃护理活动，以便他们可以保留ECHI。据我们所知，这种不可或缺的方法可以解决ECHI的激励措施和陷阱。