Is fragmented financing bad for your health?

Inquiry. 2011 Summer;48(2):109-22. doi: 10.5034/inquiryjrnl_48.02.02.


Americans finance health care through a variety of private insurance plans and public programs. This organizational fragmentation could threaten continuity of care and adversely affect outcomes. Using a large sample of veterans who were eligible for mixtures of Veterans Health Administration- and Medicare-financed care, we estimate a system of equations to account for simultaneity in the determination of financing configuration and the probability of hospitalization for an ambulatory care sensitive condition. We find that a change of one standard deviation in financing fragmentation increases the risk of an adverse outcome by one-fifth.

Publication types

  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Aged
  • Continuity of Patient Care / statistics & numerical data*
  • Female
  • Health Services Accessibility / statistics & numerical data
  • Health Status
  • Hospitalization / statistics & numerical data
  • Humans
  • Insurance Coverage / statistics & numerical data*
  • Male
  • Medicare / statistics & numerical data
  • Socioeconomic Factors
  • United States
  • United States Department of Veterans Affairs / statistics & numerical data*