Monday, April 21
Grant Miller: Managerial Incentives in Public Service Delivery
a PSC Research Project [ARCHIVE DISPLAY]
Investigator: Lauren Nicholas
Nearly one-quarter of the U.S. elderly population currently has diabetes, facing increased risk of many health conditions and raising Medicare spending by billions of dollars. A key aspect of diabetes treatment is dietary intervention. Participation in the Food Stamp Program (FSP) may improve outcomes if diabetics use food stamps to increase spending on foods that facilitate diabetes control. This study will use survey data on older Americans from the Health and Retirement Study (HRS) merged with biomarker and Medicare administrative data to test the relationships between food stamp receipt, diabetes control and Medicare costs for older diabetics.
Bloodspot data include Hemoglobin A1c (HbA1c) levels, a measure of blood sugar control over recent months and HDL (‘’good”) cholesterol level, which indicates risk of cardiovascular disease, a common diabetic morbidity. Probit and OLS regressions using pooled cross sections of data will test the relationship between food stamp receipt and measures of HbA1c, HDL cholesterol levels and body mass index for older diabetics, controlling for a rich set of individual characteristics. Recipient fixed effect regressions of Medicare spending on food stamp receipt and individual characteristics will be estimated for a sample of elderly diabetics observed between 1996 and 2005. Administrative data include Medicare spending across all care settings. Propensity score matching and instrumental variables approaches will be used to address potential endogeneity between food stamp receipt and diabetes outcomes.
Results have important implications for future changes to the FSP including efforts to increase elderly take-up rates and improve recipients’ nutrition. Evaluations of the FSP should account for any spillovers to Medicare spending. Findings from this study will provide evidence of effect of the FSP on diabetes management and the potential role of the FSP in reducing Medicare spending on diabetics.
|Funding:||Department of Agriculture (59-5000-7-0045)|
Funding Period: 10/01/2008 to 12/31/2009
Country of Focus: USA
This PSC Archive record is displayed for historical reference.