title: Hospital consolidation and racial/income disparities in health insurance coverage.
abstract: Non-Hispanic whites are significantly more likely to have health insurance coverage than most racial/ethnic minorities, and this differential grew during the 1990s. Similarly, wealthier Americans are more likely to have health insurance than the poor, and this difference also grew over the 1990s. This paper examines the role of provider competition in increasing these disparities in insurance coverage. Over the 1990s, the hospital industry consolidated; we analyze the impact of this consolidation on health insurance take-up for different racial/ethnic minorities and income groups. We found that the hospital consolidation wave increased health insurance disparities along racial and income dimensions.
authors.affiliation: Division of Health Policy and Management, School of Public Health, University of Minnesota, Minneapolis, MN, USA. rjtown@umn.edu
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Town
authors.forename: Douglas R
authors.initials: DR
authors.lastname: Wholey
authors.forename: Roger D
authors.initials: RD
authors.lastname: Feldman
authors.forename: Lawton R
authors.initials: LR
authors.lastname: Burns
mesh_terms: D000328:Adult; D000573:American Hospital Association; D016208:Databases, Factual; D005260:Female; D006273:Health Facility Merger / Q000191:economics* / Q000706:statistics & numerical data; D006297:Health Services Accessibility / Q000191:economics / Q000706:statistics & numerical data; D006801:Humans; D007182:Income; D019458:Insurance Coverage / Q000706:statistics & numerical data* / Q000639:trends; D008297:Male; D017057:Medically Uninsured / Q000208:ethnology* / Q000706:statistics & numerical data; D008875:Middle Aged; D008913:Minority Groups / Q000706:statistics & numerical data*; D011157:Population Dynamics; D044469:Racial Groups / Q000706:statistics & numerical data*; D012959:Socioeconomic Factors; D014481:United States; D019037:Urban Health Services / Q000191:economics / Q000706:statistics & numerical data