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Tamar Nobel ’08 Researching Hospital Overcrowding, Medical Insurance

By Lisbeth Redfield
Posted July 11, 2007

The emergency departments in United States hospitals are under increasing pressure due to overcrowding. Tamar Nobel '08 (Mamaroneck, N.Y.), a Hamilton student particularly dedicated to emergency care, takes this problem as her research this summer. Funded by a Levitt Fellowship and working with Visiting Assistant Professor of Economics Selcuk Eren, Nobel is studying the availability of insurance coverage and hospital emergency department visits for asthma patients.

Nobel's research investigates the causal relationship between preventative care (the ability to visit a doctor at regular intervals), private insurance coverage and the use of the emergency department (ED). She hypothesizes that patients with access to preventative care also have insurance and are less likely to rely on, or require, ED visits. Those without insurance, however, tend not to have access to preventative care and as such are more frequent users of emergency services.

Nobel will use asthma as a case study for her research. A common disease, asthma accounts for 1.9 million emergency department visits each year. It is the leading cause of ED visits among children, the 11th among adults, and is "a heavy burden on children and upon the hospital emergency departments."

The research is in two parts: a substantial reading list and a statistical analysis. Nobel spent the early part of the summer reading "an extensive literature review." Next she plans to perform a statistical analysis on data taken from the National Hospital Ambulatory Medical Care Survey, which collects information about the demographics of and services provided to patients across the country.

Although it is too early for results, Nobel suspects that her hypothesis may be correct. She added that such a conclusion to this research would provide a good argument for wider insurance coverage, which would, in turn, decrease strain on overcrowded emergency departments.

Nobel is deeply interested both in public policy and medical emergency care issues, and devised her research topic as a way of combining her two disciplines. She is, however, no stranger to summer research, having spent last summer at Hamilton working on an evaluation of the HOPE VI Program in Utica. She hopes to explore similar topics of policy and emergency care for her senior project.

A public policy major, Nobel is also an emergency medical technician with the Central Oneida County Volunteer Ambulance Corps. She plans to pursue a career as an emergency department physician, with an interest in the way that sociodemographic factors influence care in the field.

Nobel's research this summer is funded by the Levitt Research Fellows Program, operated through the Arthur Levitt Public Affairs Center. The students spend the summer working intensively in collaboration with a faculty member on an issue related to public affairs.

-- by Lisbeth Redfield


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