青少年のための民間および公共の健康保険の動向
Paul W Newacheck1, M Jane Park, Claire D Brindis
1Institute for Health Policy Studies, University of California, San Francisco, CA 94118, USA. pauln@itsa.ucsf.edu
JAMA
|March 11, 2004
まとめ
公共医療保険の拡大により,青少年,特に低所得家庭の青少年に対する無保険率が低下しました. しかし,高所得の子どものための民間保険の減少は,青少年医療保険の全体的な利益を制限しました.
科学分野:
- 公衆衛生は公衆衛生である.
- 医療サービス 研究 医療サービス
- 健康経済学 医療経済学
背景:
- 青少年の健康保険は1984年から1995年の間にほとんど変わらず,メディケイドの拡大は民間保険の減少で相殺された.
- 最近の政策イニシアチブ,例えばメディケイドの拡大や州小児健康保険プログラム (SCHIP) などは,保険率を高める新たな機会を提供している.
研究 の 目的:
- 現在の青少年健康保険の状況を評価するために.
- 保険適用に関連する人口統計的,社会経済的要因を特定する.
- 青少年に対する公的・私的医療の変化を記録する.
主な方法:
- 2002年国立健康面接調査から12,995人の若者 (10~18歳) のデータを分析した.
- 多変量分析により,対象と年齢,性別,人種,貧困,家族構造,家族規模,地域などの要因との関連を特定します.
- 2002年のデータと1984年から1995年のデータとの比較.
主要な成果:
- 青少年の無保険率は,1995年の14.1%から2002年の12.2%に低下した.
- カバレッジの向上は,貧困家庭や貧困に近い家庭の青少年に集中していた.
- 中高所得家庭の若者は,民間保険の減少により,無保険の増加を経験しました.
結論:
- 1995年から2002年の間に,未保険の青少年の有意な減少は,主に公共保険の拡大によるものです.
- 高所得の若者のための民間保険の減少は,全体的なポジティブな傾向を部分的に相殺した.
- ターゲットを絞った公的プログラムは,若者の健康保険へのアクセスを改善するために不可欠です.
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