メディケア保険の適用が,以前保険に加入していなかった成人に対する基本的な臨床サービスに及ぼす影響
J Michael McWilliams1, Alan M Zaslavsky, Ellen Meara
1Division of General Medicine and Primary Care, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Mass 02115, USA.
JAMA
|August 14, 2003
まとめ
メディケア保険の適用により,保険のない成人の臨床サービス利用は増加したが,薬物使用は変わらなかった. 手頃な価格のメディケア・オプションは,保険のない高齢者の方々に恩恵をもたらします.
科学分野:
- 医療サービス 研究 医療サービス
- 公衆衛生は公衆衛生である.
- ゲロントロジーはゲロントロジーの学科です.
背景:
- 保険に加入していない成人は,保険に加入している人と比較して,医療へのアクセスと医療成果の格差を経験しています.
- 長期的研究は,医療利用と健康状態に対する健康保険の影響を理解するために不可欠です.
研究 の 目的:
- Medicareの適格性が,以前に保険に加入した成人と保険に加入していない成人の間で,必須の臨床サービスと医薬品の利用にどのように影響するかを調べる.
主な方法:
- 1996年と2000年の健康と退職に関する調査の全国的に代表的なデータの分析.
- 1996年に60歳から64歳までの成人2203人を対象に,保険状態 (継続的に無保険,間欠的に無保険,継続的に有保険) により分類した.
- コレステロール検査,マンモグラフィー,前立腺検査,関節炎および高血圧の治療を受けたと自己報告した人の評価.
主要な成果:
- メディケアの適格性は,無保険と有保険の成人の間のコレステロール検査,マンモグラフィー,前立腺検査の格差を大幅に軽減しました.
- 基本的臨床サービスの利用はメディケア以降,以前保険に入っていなかった個人に増加したが,抗高血圧薬の使用は変わらなかった.
- 関節炎を患う未保険の成人は,メディケアを受け入れた後,より多くの医師の診察と活動制限を報告したが,治療は増加しなかった.
結論:
- 以前保険に入っていなかった成人は,メディケアでカバーされる臨床サービスの利用が増加したが,医薬品の利用は増加しなかった.
- 研究結果は,手頃な価格のメディケア購入オプションを提供することで,保険のない高齢者の医療へのアクセスを改善できると示唆しています.
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