The DOI matches its Crossref record.
Does Free Care Improve Adults' Health?: Results from a Randomized Controlled Trial
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.
Overview
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Verification
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Citations
Cited by
Norman, G. R., Sloan, J. A., & Wyrwich, K. W. (2003) · Medical Care · doi:10.1097/01.mlr.0000062554.74615.4c · Cited by 4,700
McHorney, C. A., Ware, J. E., Rachel Lu, J. F., & Sherbourne, C. D. (1994) · Medical Care · doi:10.1097/00005650-199401000-00004 · Cited by 4,458
Self-citationBalboa-Castillo, T., León-Muñoz, L. M., Graciani, A., Rodríguez-Artalejo, F., & Guallar-Castillón, P. (2011) · Health and Quality of Life Outcomes · doi:10.1186/1477-7525-9-47 · Cited by 325
The challenge of rising health care costs – a view from the Congressional Budget Office
Orszag, P. R., & Ellis, P. (2007) · New England Journal of Medicine · doi:10.1056/nejmp078190 · Cited by 224
Patient-Reported Measures of Health: The Veterans Health Study
Kazis, L. E., Miller, D. R., Skinner, K. M., Lee, A., Ren, X. S., Clark, J. A., Rogers, W. H., Spiro, A., Selim, A., Linzer, M., et al. (2004) · Journal of Ambulatory Care Management · doi:10.1097/00004479-200401000-00012 · Cited by 207
Self-citationMedication Nonadherence in Diabetes
Egede, L. E., Gebregziabher, M., Dismuke, C. E., Lynch, C. P., Axon, R. N., Zhao, Y., & Mauldin, P. D. (2012) · Diabetes Care · doi:10.2337/dc12-0572 · Cited by 195
Mann, B. S., Barnieh, L., Tang, K., Campbell, D. J. T., Clement, F., Hemmelgarn, B., Tonelli, M., Lorenzetti, D., & Manns, B. J. (2014) · PLoS ONE · doi:10.1371/journal.pone.0089168 · Cited by 66
Demographic differences in health status of homeless adults
Gelberg, L., & Linn, L. S. (1992) · Journal of General Internal Medicine · doi:10.1007/bf02599198 · Cited by 61
Black, B., Hollingsworth, A., Nunes, L., & Simon, K. (2022) · Journal of Public Economics · doi:10.1016/j.jpubeco.2022.104713 · Cited by 31
Campbell, D. J. T., Mitchell, C., Hemmelgarn, B. R., Tonelli, M., Faris, P., Zhang, J., Tsuyuki, R. T., Fletcher, J., Au, F., Klarenbach, S., et al. (2023) · Circulation · doi:10.1161/circulationaha.123.064188 · Cited by 23
Methods for explaining the clinical significance of health status measures
Guyatt, G., Osoba, D., Wu, A., Wyrwich, K., & Norman, G. (2002) · Clinical Therapeutics · doi:10.1016/s0149-2918(02)85088-3 · Cited by 10
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
- Publisher
- Massachusetts Medical Society
- 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
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
Data sources
Bibliographic data: Semantic Scholar, OpenAlex, Crossref.
Contains information from the Semantic Scholar Academic Graph Datasets, made available under the ODC Attribution License (ODC-BY 1.0).
Semantic Scholar’s data is described in: Kinney, R., et al. (2023). The Semantic Scholar Open Data Platform. arXiv:2301.10140.