关于医疗保健可及性的三篇论文（英）-131页.pdf

ThreeEssaysonHealth

CareAccess

LAWRENCEBAKER

ThisdocumentwassubmittedasadissertationinJanuary2025inpartialfulillmentof

therequirementsoftheFrederickS.PardeePh.D.inPolicyAnalysisattheRANDSchool

ofPublicPolicy.Thefacultycommitteethatsupervisedandapprovedthedissertation

consistedofRolandSturm(chair),JodiLiu,AshleyKranz,andBryanTysinger(outside

reader).

ThisdissertationwasgenerouslysupportedbytheAnnandJamesRothenberg

DissertationAwardandbytheCentersontheDemographyandEconomicsofAging-

CoordinatingCenterTravelAward(R24AG066588).

Approvedforpublicrelease;distributionisunlimited.

Formoreinformationonthispublication,visit/t/RGSDA4280-1.

AbouttheRANDSchoolofPublicPolicy

TheRANDSchoolofPublicPolicyhasspecializedingraduate-levelpolicyeducationsinceitsfoundingin1970.TheRANDSchoolis

hometotheFrederickS.PardeePh.D.inPolicyAnalysis,whichistheoriginalpublicpolicyPh.D.programintheUnitedStatesand

theonlyPh.D.programbasedatanindependentpublicpolicyresearchorganization.TolearnmoreabouttheRANDSchoolofPublic

Policy,visit.

Publishedin2025bytheRANDCorporation,SantaMonica,Calif.

isaregisteredtrademark.

Abstract

Governmenthealthprogramsmustbalancemaximizingaccesswithcontrollingcostswhile

consideringequity,geographicvariation,andresourceconstraints.Healthcarereforms,whether

inpaymentsystems,qualitymeasures,ornewtechnologies,cansignificantlyimpacthealthcare

access.Thisdissertationexamineshowpolicychangesinthreegovernmenthealthprograms

affectaccesstocareacrossdifferentsettings.

Chapter1analyzesracialandethnicdisparitiesinCOVID-19vaccinedistribution,providingthe

firstnationalanalysisofracialdisparitiesinboosteruptake.Thisstudymakesmethodological

contributionsbycalculatingvaccinationratesbasedonel