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    The DC Healthcare Alliance and Access to Care: The effect of increased insurance coverage and a dispersed safety net on access to healthcare in the District of Columbia

    Cover for The DC Healthcare Alliance and Access to Care: The effect of increased insurance coverage and a dispersed safety net on access to healthcare in the District of Columbia
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    View/Open: Turner_georgetown_0076M_11706.pdf (678kB) Bookview

    Creator
    Turner, Benjamin
    Advisor
    Komisar, Harriet L
    Abstract
    In 2001, the District of Columbia (DC) fundamentally changed its system of safety-net healthcare. The District closed its public hospital; created an insurance program for low-income residents, the DC Healthcare Alliance; shifted control of its publicly-run clinics to nonprofits; expanded Medicaid coverage; and invested in safety-net providers. DC shifted from directly providing healthcare to providing coverage and promoting care through private providers.
     
    This shift in priorities and structure offers an opportunity to examine the effects of increasing coverage and promoting primary care on access to healthcare. Using annual cross-sectional data from the Center for Disease Control's Behavioral Risk Factor Surveillance System from 1998 to 2006, I conduct multivariate regression analysis controlling for individual demographics, socioeconomic status, and health status, as well as pre-reform trends in DC and pre- and post-reform trends among a comparison group of eleven metropolitans in the region.
     
    Analysis finds that DC's reforms are associated with improved access to healthcare in three of four outcomes and improved access trends in all four outcomes. Among non-elderly adults in DC, the reforms reduced the uninsured population by 5.7 percentage points; reduced the population delaying care due to cost by 17.3 percentage points; reduced the population without a personal doctor by 6.4 percentage points; and increased the population without an annual checkup by 2 percentage points. The effectiveness of DC's reforms suggests that policymakers seeking to improve access can do so by increasing coverage and promoting safety-net providers.
     
    Description
    M.P.P.
    Permanent Link
    http://hdl.handle.net/10822/557840
    Date Published
    2012
    Subject
    Access to Care; DC General; DC Healthcare Alliance; District of Columbia; Health Access; Health Insurance; Public health; Public policy; Public health; Public policy;
    Type
    thesis
    Publisher
    Georgetown University
    Extent
    87 leaves
    Collections
    • Graduate Theses and Dissertations - Public Policy
    Metadata
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    Georgetown University Seal
    ©2009 - 2023 Georgetown University Library
    37th & O Streets NW
    Washington DC 20057-1174
    202.687.7385
    digitalscholarship@georgetown.edu
    Accessibility