移民の国の公的保険制度と産後ケア
Maria W Steenland1, Rachel E Fabi2, Meghan Bellerose3
1Population Studies and Training Center, Brown University, Providence, Rhode Island.
JAMA
|July 18, 2023
まとめ
公的保険の制限により 移民の産後ケアへのアクセスが 制限されています この政策の障壁は 妊婦の健康に影響を及ぼし 包摂的な政策の必要性を強調しています
科学分野:
- 公衆衛生
- 医療サービス研究
- 健康政策
背景:
- すべての成人に定期的な産後ケアが推奨されます.
- いくつかの州では,不法移民や最近登録された移民の公的保険を制限しています.
- これらの制限は 産後必需医療への障壁を 引き起こします
研究 の 目的:
- 低所得移民の公的保険と産後ケアとの関連を調査する.
- 移民と非移民の分娩後のケアへのアクセスを 比較する
主な方法:
- 妊娠リスク評価モニタリングシステムのデータ (2012年−2019年) の総合的横断分析
- 19州とニューヨーク市で 生きた子を出産した 低所得の成人を含む
- 移民の国有保険のカテゴリー (完全,中等,無保険) に基づく産後介護の受領証
主要な成果:
- 産後介護の公的保険が 適度な程度か全くない州に住む移民は 完全保険の州に住む移民より 少ない割合で受診しています
- 保険の制限がある州では 移民と非移民の分娩後の介護の格差が大きい.
- 具体的には,移民の産後ケア受給率は,完全カバーの州と比較して,中等な/無カバーの州で7.0から11.3パーセントポイント低かった.
結論:
- 公的保険の制限は,移民の産後ケアへのアクセスを減少させています.
- 保険の制限などの政策による障壁は 移民の母親の健康に悪影響を及ぼします
- 産後介護のための公的保険の範囲を拡大することで 移民の健康上の公平性を改善できます
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