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Does Medicare Save Lives? *
Open accessAbstract
Health insurance characteristics shift at age 65 as most people become eligible for Medicare. We measure the impacts of these changes on patients who are admitted to hospitals through emergency departments for conditions with similar admission rates on weekdays and weekends. The age profiles of admissions and comorbidities for these patients are smooth at age 65, suggesting that the severity of illness is similar on either side of the Medicare threshold. In contrast, the number of procedures performed in hospitals and total list charges exhibit small but statistically significant discontinuities, implying that patients over 65 receive more services. We estimate a nearly 1-percentage-point drop in 7-day mortality for patients at age 65, equivalent to a 20% reduction in deaths for this severely ill patient group. The mortality gap persists for at least 9 months after admission.
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“Specifically the period from 1940 to 1955 was also one in which the use of antibiotics in the treatment of infectious disease emerged and grew in clinical medicine”
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“the period 1971 to 1985 saw the growth of Medicare and improvement in the treatment and prevention of life-threatening chronic diseases, especially heart disease.”
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Metadata
- Authors
- Card, D., Dobkin, C., & Maestas, N.
- Affiliations
- University of California, Berkeley (US)
- University of California, Santa Cruz (US)
- RAND Corporation (US)
- Venue
- Quarterly Journal of Economics
- Publisher
- Oxford University Press (OUP)
- Published
- 2009-05
- Volume
- 124
- Issue
- 2
- Pages
- 597-636
- ISSN
- 0033-5533 (ISSN-L)
- 1531-4650
- PMC
- PMC2777733
- OpenAlex
- W2145644832
- Cited by
- 494
- References
- 40
- Citations by year
- 2026: 17 · 2025: 17 · 2024: 28 · 2023: 29 · 2022: 30 · 2021: 40 · 2020: 33 · 2019: 33 · 2018: 21 · 2017: 37 · 2016: 39 · 2015: 38 · 2014: 36 · 2013: 28 · 2012: 28
- FWCI
- 48.48
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- The Quarterly Journal of Economics (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- RePEc: Research Papers in Economics (submittedVersion)
- Funders
- National Institute on Aging (R01AG026290, R03AG025155)
- Topics
- Social Sciences › Economics, Econometrics and Finance › Economics and Econometrics › Healthcare Policy and Management
- Health Sciences › Medicine › Emergency Medicine › Emergency and Acute Care Studies
- Health Sciences › Nursing › Leadership and Management › Hospital Admissions and Outcomes
- Keywords
- Medicare, health insurance coverage, emergency department admission, hospital discharge, mortality, older adults, comorbidities, hospital procedures, life expectancy
- MeSH terms
- Aged, Medicare, Humans, Middle Aged, Mortality, United States
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 ›
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