Preserving health among vulnerable populations: Three essays.
详细信息
文摘
This dissertation consists of three stand-alone essays that focus on the economics of preserving health among vulnerable population, specifically chronic ill and elderly population. First paper focuses on elderly population. It examines Medicare Part D beneficiaries choice of when to take up Part D in its initial enrollment period IEP). The findings show consumers responded to financial incentive embedded in Part D and made their decision accordingly. Elderly consumers tend to enroll earlier if they were facing higher level or greater variation of prescription drug out-of-pocket spending. The result also implies the need of public effort to facilitate the enrollment decision. Chronic Kidney Disease CKD) is increasingly a public health concern in the United States. In the second paper, we developed a microsimulation model as a base of cost-effectiveness analysis of alternative CKD intervention strategies. Using a nationally representative sample, the model generates a large number of life histories over the next 20 years. The model provides a consistent analytical framework for the evaluation of alternative CKD interventions. The third paper examines the impact of improving high blood pressure control on CKD outcomes at population level. The strategy was found improves the health outcomes of CKD and save life-time medical cost. The cost savings on the ESRD associated health care is substantial, offsetting the investment on the upstream hypertension control. The results support that more public health efforts should be directed to improve the hypertension awareness and control as one effective early intervention strategy on CKD.