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Additional Analysis Regarding the Monitoring of New Hampshire Health Insurance

Additional Analysis

This report has noted that discharge data will not provide an absolute measure of the rate of uninsurance in New Hampshire. It might be possible with more detailed analysis, however, to develop a formula that age-adjusts the raw numbers and benchmarks them so that the result is a very good approximation of the absolute measure of the percentage of the population without health insurance. With experience, other measures might also be collected and used to supplement this proposed measure. For example, the self-pay portion of hospital outpatients, of patient-days, of outpatient discharges, or of emergency room visits might be used to confirm trends or fine-tune the estimate of the percentage of the uninsured in the population as a whole.

The UHDD data set is sufficiently large to allow analysis of any changes in apparent insurance coverage to include subsets of persons by age group, by geographical location, and other factors. This should be done on an annual basis.

Using the suggested proxy of hospital admissions should provide a way to monitor changes in the insurance status of New Hampshire residents that will be more accurate and more timely than surveys of the population and at essentially no additional cost. Surveys will still be necessary to determine attitudes toward health care and health insurance, reasons for lack of insurance, and other issues. But these could, perhaps, be done less often if the suggested proxy is used to track short term changes in the basic rate of uninsurance.