Nature of Ota’s Review and Synthesis

To conduct the literature review, OTA’s contractors searched several scientific literature databases for articles published since 1980 on the relationships among the sources of health insurance; the utilization, process, and quality of medical services; and outcomes of care (178). OTA focused the review on multivariate studies that statistically adjusted, or otherwise attempted to correct for, competing explanations for results. Studies of differences in the use of health services have compared: uninsured to privately insured individuals, uninsured to publicly covered individuals, uninsured individuals to those with both public and private coverage, and/or publicly covered to privately insured individuals.