医疗保险覆盖范围对以前没有保险的成年人基本临床服务的影响
J Michael McWilliams1, Alan M Zaslavsky, Ellen Meara
1Division of General Medicine and Primary Care, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Mass 02115, USA.
JAMA
|August 14, 2003
概括
获得医疗保险覆盖率增加了未保险成年人的临床服务使用率,但药物使用率保持不变. 一个负担得起的医疗保险选择可能会使近年龄的无保险个人受益.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 公共卫生 公共卫生
- 老年学是一门学科.
背景情况:
- 与保险人相比,没有保险的成年人在医疗保健获得和结果方面存在差异.
- 纵向研究对于了解医疗保险对医疗保健利用和健康状况的影响至关重要.
研究的目的:
- 检查医疗保险资格如何影响以前有保险的成年人与没有保险的成年人使用基本临床服务和药物.
主要方法:
- 对1996年和2000年的健康和退休研究数据进行了全国代表性的分析.
- 包括1996年60-64岁的2203名成年人,按保险状况分类 (持续无保险,间歇无保险,持续保险).
- 评估自我报告的胆固醇检测,乳房影像,前列腺检查以及关节炎和高血压的治疗.
主要成果:
- 医疗保险的资格显著减少了无保险和有保险的成年人之间的胆固醇检测,乳房影像和前列腺检查的差异.
- 虽然以前没有保险的个人在医疗保险后使用基本临床服务增加了,但他们使用抗高血压药物的情况没有改变.
- 在获得医疗保险后,患有关节炎的未保险成年人报告了更多的医生访问和活动限制,但没有增加治疗.
结论:
- 以前没有保险的成年人表明,医疗保险覆盖的临床服务的吸收增加,但不是药物.
- 调查结果表明,提供负担得起的医疗保险购买选择可以改善近年人没有保险的人群获得医疗保健的机会.
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