米国におけるHIV治療と予防の保険と資金調達状況
Jennifer Kates1, Lindsey Dawson1, Tim H Horn2
1Henry J Kaiser Family Foundation, Washington, DC, USA.
Lancet (London, England)
|February 22, 2021
まとめ
医療保障法により 医療保険の範囲が拡大しましたが HIV治療制度は 複雑です 保険不足が減ったにもかかわらず アメリカは他の高所得国と比較して HIV ウイルスの抑制率が遅れています
科学分野:
- 公衆衛生
- 健康政策
- 流行病学について
背景:
- 医療保険制度は2010年に Affordable Care Act (ACA) によって大きく変化した.
- HIVに感染した人や 感染リスクのある人など 何百万人も対象になりました
- 米国でのHIV治療と予防は 支払者,提供者,資金提供者の複雑なネットワークです
研究 の 目的:
- 米国におけるHIV治療と予防のカバーと資金提供について概要を述べる.
- ACAがHIVに対する国内医療システムに与える影響を議論する.
- 主要なHIVケアプログラムを調査し,継続的な課題を特定する.
主な方法:
- 医療保険の見直し HIV サービスへの資金調達メカニズム
- 低価格医療法がHIV感染率に及ぼす影響の分析
- ライアン・ホワイト HIV/AIDSプログラムを含む主要なHIV/AIDSプログラムの検討
主要な成果:
- HIV感染者は主にメディケイド,メディケア,民間保険,ライアン・ホワイトのHIV/AIDSプログラムを利用しています.
- ライアン・ホワイトのHIV/AIDSプログラムは,未保険者/未保険者のためのセーフティネットとして機能しますが,予防支援は限られています.
- 保険不足が減少したにもかかわらず,米国では他の高所得国よりもウイルスの抑制率が低い.
結論:
- ACAは米国の健康保険の形を変えましたが HIV治療の資金調達とアクセスには 課題が残っています
- HIV治療の分散は 治療と予防の全体的な効果に 影響を及ぼします
- 残されたギャップを解決することは,米国におけるHIV特有の健康指標の改善に不可欠です.
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