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Is fragmented financing bad for your health?
Steven D Pizer1, John A Gardner
1Health Care Financing and Economics, U.S. Department of Veterans Affairs, 150 South Huntington Ave. (152H), Boston, MA 02130, USA. pizer@bu.edu
Summary
Healthcare financing fragmentation, mixing private insurance and public programs, increases adverse health outcomes. This study shows fragmented care for veterans significantly raises risks, impacting patient health.
Area of Science:
- Health Services Research
- Health Economics
- Public Health Policy
Background:
- Healthcare financing in the U.S. involves diverse private insurance plans and public programs.
- Organizational fragmentation in healthcare financing may compromise care continuity and negatively impact patient outcomes.
Purpose of the Study:
- To investigate the relationship between healthcare financing fragmentation and adverse health outcomes.
- To quantify the impact of mixed financing configurations on hospitalization risk for ambulatory care sensitive conditions.
Main Methods:
- Utilized a large sample of U.S. veterans eligible for both Veterans Health Administration and Medicare financing.
- Employed a system of equations to model the simultaneity between financing configuration and hospitalization probability.
- Analyzed ambulatory care sensitive conditions as a proxy for preventable adverse events.
Main Results:
- A one standard deviation increase in financing fragmentation was associated with a one-fifth increase in the risk of an adverse outcome.
- The study highlights a significant link between fragmented healthcare funding and poorer patient health results.
- Veterans with mixed financing experienced higher risks, underscoring the impact of system complexity.
Conclusions:
- Healthcare financing fragmentation poses a tangible risk to patient outcomes.
- Policy interventions aimed at streamlining healthcare financing could improve care continuity and reduce adverse events.
- Addressing the complexity of mixed public and private healthcare funding is crucial for enhancing veteran health and overall public health.
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