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Does Free Care Improve Adults' Health?: Results from a Randomized Controlled Trial

Brook, Robert H., Ware, John E., Rogers, William H., Keeler, Emmett B., Davies, Allyson R., Donald, Cathy A., Goldberg, George A., Lohr, Kathleen N., Masthay, Patricia C., Newhouse, Joseph P.·1983·New England Journal of Medicine

Abstract

Does free medical care lead to better health than insurance plans that require the patient to shoulder part of the cost? In an effort to answer this question, we studied 3958 people between the ages of 14 and 61 who were free of disability that precluded work and had been randomly assigned to a set of insurance plans for three or five years. One plan provided free care; the others required enrollees to pay a share of their medical bills. As previously reported, patients in the latter group made approximately one-third fewer visits to a physician and were hospitalized about one-third less often. For persons with poor vision and for low-income persons with high blood pressure, free care brought an improvement (vision better by 0.2 Snellen lines, diastolic blood pressure lower by 3 mm Hg); better control of blood pressure reduced the calculated risk of early death among those at high risk. For the average participant, as well as for subgroups differing in income and initial health status, no significant effects were detected on eight other measures of health status and health habits. Confidence intervals for these eight measures were sufficiently narrow to rule out all but a minimal influence, favorable or adverse, of free care for the average participant. For some measures of health in subgroups of the population, however, the broader confidence intervals make this conclusion less certain.

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Crossref · 10.1056/nejm198312083092305

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Metadata

Authors
Brook, R. H., Ware, J. E., Rogers, W. H., Keeler, E. B., Davies, A. R., Donald, C. A., Goldberg, G. A., Lohr, K. N., Masthay, P. C., & Newhouse, J. P.
Venue
New England Journal of Medicine
Published
1983-12-08
Volume
309
Issue
23
Pages
1426-1434
ISSN
  • 0028-4793 (ISSN-L)
  • 1533-4406
OpenAlex
W207045513
Cited by
666
References
0
FWCI
98.49
Type
journal article
Language
en
Open access
closed

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Contains information from the Semantic Scholar Academic Graph Datasets, made available under the ODC Attribution License (ODC-BY 1.0).

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