Does Uninsurance Affect the Health Outcomes of the Insured? Evidence from Heart Attack Patients in California

CentER Discussion Paper Series No. 2012-027

64 Pages Posted: 27 Mar 2012

Multiple version iconThere are 2 versions of this paper

Date Written: March 26, 2012

Abstract

In this paper, I examine the impact of uninsured patients on the health of the insured, focusing on one health outcome | the in-hospital mortality rate of insured heart attack patients. I employ panel data models using patient discharge and hospital financial data from California (1999-2006). My results indicate that uninsured patients have an economically significant effect that increases the mortality rate of insured heart attack patients. I show that these results are not driven by alternative explanations, including reverse causality, patient composition effects, sample selection or unobserved trends and that they are robust to a host of specification checks. My results also indicate that the primary channel for the observed spillover effects is increased hospital uncompensated care costs. Although data limitations constrain my capacity to check how hospitals change their provision of care to insured heart attack patients in response to reduced revenues, the evidence I have suggests a modest increase in the quantity of cardiac services without a corresponding increase in hospital staff.

Keywords: Uninsurance, Spillovers, Heart Attack Mortality, Hospitals

JEL Classification: I10, I11, I18

Suggested Citation

Daysal, N. Meltem, Does Uninsurance Affect the Health Outcomes of the Insured? Evidence from Heart Attack Patients in California (March 26, 2012). CentER Discussion Paper Series No. 2012-027, Available at SSRN: https://ssrn.com/abstract=2028974 or http://dx.doi.org/10.2139/ssrn.2028974

N. Meltem Daysal (Contact Author)

Tilburg University ( email )

P.O. Box 90153
Tilburg, DC Noord-Brabant 5000 LE
Netherlands

HOME PAGE: http://www.meltemdaysal.com

IZA ( email )

P.O. Box 7240
Bonn, D-53072
Germany

HOME PAGE: http://www.meltemdaysal.com

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