Presented By: Department of Economics
Health, History, Demography & Development (H2D2)
Shooshan Danagoulian, Wayne State University and Martha Bailey, University of Michigan
Shooshan will be presenting Office Visits Preventing Emergency Room Visits: Evidence from the Flint Water Switch.
Abstract: Emergency department visits are costly to providers and to patients. We use the Flint water crisis to test if an exogenous increase in office visits reduced avoidable emergency room visits. In September 2015, citizens in Flint became aware of increased lead levels in their drinking water, resulting from the switch from Lake Huron to the Flint River. Using Medicaid claims for 2013-2016, we find that this information shock increased the share of enrollees with lead tests by 1.7 percentage points. Additionally, it increased office visits immediately following the information shock, then decreased them afterwards. This led to a reduction of 4.9 preventable, non-emergent, and primary care treatable emergency room visits per 1000 eligible children (8.2%). This decrease is present in shifts from emergency room visits to office visits across several common conditions. Our results suggest following lead tests, children were more likely to receive care from the same clinic and that establishing care reduces the likelihood a parent will take their child to receive care at the emergency room for conditions treatable in an office setting. Our results are potentially applicable to any situation in which individuals are induced to seek more care in an office visit setting.
Martha will be presenting Reducing Out-of-Pocket Costs for Contraceptives Increases Use among Low-Income Women.
Abstract: In the U.S., nearly half of pregnancies are unintended, and unintended pregnancies occur twice as often among poor relative than in the U.S. population overall. The cost of effective contraception may be among the most important drivers of unintended pregnancies. Even with generous subsidies under Title X of the Public Health Services Act, the insertion of an IUD at Planned Parenthood costs $223 for uninsured women earning between 100 and 150% of the poverty line. To examine the role of costs in determining the use of contraception, the Michigan Contraceptive Access, Research, and Evaluation Study (M-CARES) has randomized over 1,800 women at Michigan Planned Parenthood (PPMI) clinics to receive vouchers that reduce out-of-pocket costs for contraceptives. Using follow-up surveys and administrative records, we report on how vouchers for contraceptives impacted the use of any birth control the use of long-run acting contraceptives.
Abstract: Emergency department visits are costly to providers and to patients. We use the Flint water crisis to test if an exogenous increase in office visits reduced avoidable emergency room visits. In September 2015, citizens in Flint became aware of increased lead levels in their drinking water, resulting from the switch from Lake Huron to the Flint River. Using Medicaid claims for 2013-2016, we find that this information shock increased the share of enrollees with lead tests by 1.7 percentage points. Additionally, it increased office visits immediately following the information shock, then decreased them afterwards. This led to a reduction of 4.9 preventable, non-emergent, and primary care treatable emergency room visits per 1000 eligible children (8.2%). This decrease is present in shifts from emergency room visits to office visits across several common conditions. Our results suggest following lead tests, children were more likely to receive care from the same clinic and that establishing care reduces the likelihood a parent will take their child to receive care at the emergency room for conditions treatable in an office setting. Our results are potentially applicable to any situation in which individuals are induced to seek more care in an office visit setting.
Martha will be presenting Reducing Out-of-Pocket Costs for Contraceptives Increases Use among Low-Income Women.
Abstract: In the U.S., nearly half of pregnancies are unintended, and unintended pregnancies occur twice as often among poor relative than in the U.S. population overall. The cost of effective contraception may be among the most important drivers of unintended pregnancies. Even with generous subsidies under Title X of the Public Health Services Act, the insertion of an IUD at Planned Parenthood costs $223 for uninsured women earning between 100 and 150% of the poverty line. To examine the role of costs in determining the use of contraception, the Michigan Contraceptive Access, Research, and Evaluation Study (M-CARES) has randomized over 1,800 women at Michigan Planned Parenthood (PPMI) clinics to receive vouchers that reduce out-of-pocket costs for contraceptives. Using follow-up surveys and administrative records, we report on how vouchers for contraceptives impacted the use of any birth control the use of long-run acting contraceptives.
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