青少年私人和公共医疗保险的发展趋势
Paul W Newacheck1, M Jane Park, Claire D Brindis
1Institute for Health Policy Studies, University of California, San Francisco, CA 94118, USA. pauln@itsa.ucsf.edu
JAMA
|March 11, 2004
概括
公共医疗保险的扩展减少了青少年的无保险率,特别是那些来自低收入家庭的青少年. 然而,对于收入较高的儿童来说,私人保险的下降限制了青少年健康保险的整体收益.
科学领域:
- 公共卫生 公共卫生
- 医疗保健服务研究 医疗服务研究
- 卫生经济学 卫生经济学
背景情况:
- 在1984年至1995年期间,青少年医疗保险覆盖率基本保持不变,医疗补助计划的扩张被私人覆盖率的下降所抵消.
- 最近的政策举措,包括医疗补助扩展和国家儿童健康保险计划 (SCHIP),为增加覆盖率提供了新的机会.
研究的目的:
- 评估当前的青少年健康保险状况.
- 确定与保险覆盖相关的人口和社会经济因素.
- 记录青少年公共和私人覆盖的变化.
主要方法:
- 分析了2002年国家健康访谈调查中12995名青少年 (10-18岁) 的数据.
- 多变量分析以确定覆盖率与年龄,性别,种族,贫困,家庭结构,家庭规模和地区等因素之间的关联.
- 将2002年的数据与1984年至1995年的数据进行比较.
主要成果:
- 青少年的无保险率从1995年的14.1%下降到2002年的12.2%,主要是由于公共保险覆盖率的增加.
- 覆盖率的增长主要集中在贫困和近贫困家庭的青少年中.
- 中高收入家庭的青少年由于私人保险覆盖率下降,无保险率上升.
结论:
- 在1995年至2002年期间,没有保险的青少年发生了显著的减少,主要是由于公共保险的扩大.
- 对于收入较高的青少年来说,私人保险的减少部分抵消了整体的积极趋势.
- 有针对性的公共计划对于改善青少年获得医疗保险的机会至关重要.
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