State‐Level Unemployment and the Utilization of Preventive Medical Services. (16th July 2013)

• Record Type: Journal Article
• Authors: Tefft, Nathan; Kageleiry, Andrew
• Is Part Of: Health services research. Volume 49:Number 1(2014:Feb.)
• Page Start: 186
• Page End: 205
• Publication Date: 2013-07-16
• Subjects: Medical care -- Periodicals; Medical care -- Evaluation -- Periodicals; Hospital care -- Periodicals; Health services administration -- Periodicals; 362
• DOI: 10.1111/1475-6773.12091
• Languages: English
• ISSNs: 0017-9124

Abstract

<abstract abstract-type="main" id="hesr12091-abs-0001"> <title> <x xml:space="preserve">Abstract</x> </title> <sec id="hesr12091-sec-0001" sec-type="section"> <title>Objective</title> <p>To study the association between macroeconomic conditions and preventive medical service utilization.</p> </sec> <sec id="hesr12091-sec-0002" sec-type="section"> <title>Data Sources/Study Setting</title> <p>Secondary data collection of a survey of the civilian, non‐institutionalized population of adults (age 18 and older) in the United States between 1987 and 2010.</p> </sec> <sec id="hesr12091-sec-0003" sec-type="section"> <title>Study Design</title> <p>Regression analyses that adjust for individual‐level demographic and socioeconomic determinants, state and time‐fixed effects, and state‐specific time trends.</p> </sec> <sec id="hesr12091-sec-0004" sec-type="section"> <title>Data Collection/Extraction Methods</title> <p>State health departments, with technological and methodological assistance from the Centers for Disease Control and Prevention, conducted a cross‐sectional yearly telephone survey using a standardized questionnaire.</p> </sec> <sec id="hesr12091-sec-0005" sec-type="section"> <title>Principal Findings</title> <p>The use of preventive medical services is procyclical: a 1 percentage point increase in the state‐level unemployment rate is associated with a 1.58 percent decrease in the quantity of distinct preventive care services utilized. Women and economically disadvantaged populations are shown to be especially sensitive to macroeconomic fluctuations.</p> </sec> <sec id="hesr12091-sec-0006" sec-type="section"> <title>Conclusions</title> <p>Policy makers should be aware of cyclical changes in preventive care use, particularly among disadvantaged populations, when making challenging budgetary decisions during economic downturns. As physician recommendations can have a strong impact on patients' use, health care providers could increase efforts to persuade patients to seek screening exams and necessary vaccinations during periods of high unemployment.</p> </sec> </abstract>