最近の移民や不法移民に対する緊急のメディケイド支出の動向
C Annette DuBard1, Mark W Massing
1Cecil G. Sheps Center for Health Services Research, University of North Carolina, Chapel Hill, NC 27599, USA. adubard@schsr.unc.edu
JAMA
|March 16, 2007
まとめ
ノースカロライナ州の緊急メディケイドは,主に書類のない移民の出産や妊娠の合併症をカバーしています. 支出は,特に高齢者や障害者向けに増加しており,怪我も重要なコストドライバーとなっています.
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
- 移住 健康 移民
背景:
- 不法移民や最近の合法移民は,メディケイドの資格制限に直面し,緊急サービスを除いて,ケアへのアクセスが制限されています.
- 移民人口の急速な増加は,彼らの医療利用パターンと緊急メディケイド利用を理解することを必要としています.
研究 の 目的:
- ノースカロライナ州の不法移民や最近の移民の緊急メディケイド利用率を分析する.
- 緊急メディケイドに関連する患者の人口統計,診断,支出の動向を特定する.
主な方法:
- ノースカロライナ州メディケイドの2001年から2004年の行政データに関する記述的分析.
- 入会基準は,メディケイドの資格を満たす個人に焦点を当てましたが,移民の状況により完全なカバーから除外されました.
主要な成果:
- 緊急メディケイドを利用した人は48,391人近くで,主に不法移民 (99%),ヒスパニック (93%),女性 (95%),18-40歳 (89%) でした.
- 総支出は2001年から2004年にかけて28%増加し,高齢者や障害のある患者の成長率は高かった.
- 出産と妊娠の合併症は,2004年の支出の大部分 (82%) と入院 (91%) を占めた.
結論:
- ノースカロライナ州の緊急メディケイドは,書類のない移民の出産と妊娠関連のケアに広く利用されています.
- 出産が支出を支配する一方で,高齢者や障害のある移民集団の支出の増加がより速いことが観察されています.
- 妊娠していない移民にとって,急性怪我や重度の慢性疾患の合併症は,Emergency Medicaidの使用の主な理由です.
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