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ラテン系アメリカ人の病気の費用に対する保険
R B Valdez1, H Morgenstern, R Brown
1Department of Health Services, UCLA School of Public Health 90024-1772.
JAMA
|February 17, 1993
まとめ
医療改革戦略は,保険の範囲を向上させることができるが,多くのラテン系の人々は,独特の人口統計的,経済的要因のために依然として保険がない可能性がある.
科学分野:
- 医療サービス 研究 医療サービス
- 健康政策 保健政策 保健政策
- 健康の社会学 健康の社会学
背景:
- ラテン系アメリカ人は,米国内の他の民族集団と比較して,健康保険のカバーにおいて最も大きな格差を経験しています.
- この覆盖のギャップの決定要因を理解することは,効果的な健康政策にとって極めて重要です.
- 以前の研究は,少数民族の保健医療へのアクセスをめぐる不平等が続いていることを示している.
研究 の 目的:
- 米国・ラテン系アメリカ人の医療保険の適用に影響を与える要因を分析する.
- 医療改革戦略がラテン系住民の医療対象に与える影響の違いを評価する.
- これらの改革がより広範な米国民族の景観に及ぼす影響を評価する.
主な方法:
- 1980年と1990年の現在の人口調査のデータを活用した.
- 非高齢のラテン系アメリカ人 (65歳未満) と非ヒスパニック系白人 (アングロス),黒人,アジア人の保険状況の比較.
- 共同変数と改革戦略のシミュレートされた効果の推定割り算.
主要な成果:
- ラテン系アメリカ人は,アングロ・アメリカン (13.8%) と黒人 (24%) と比較して,最も高い無保険率 (39%) を表しています.
- 貧困層やすべての労働者をカバーするポリシーは,グループ全体で無保険率を大幅に低下させることができ,ラテン系アメリカ人 (37%) の顕著な利益があります.
- 潜在的改善にもかかわらず,ラテン系は改革後の絶対的な高無保険率を維持すると予測されています.
結論:
- メディケイドの資格,労働力参加,家族構造の格差は,ラテン系アメリカ人に独特の影響を及ぼします.
- 雇用者権限,pay-or-play,およびメディケイドの拡大などのターゲットを絞った戦略は,保険の範囲を拡大することができます.
- ターゲットを絞った介入であっても,ラテン系アメリカ人のかなりの割合が保険に加入しないままになる可能性があります.
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