根据"负担得起的医疗保健法",自报的保险覆盖范围,医疗保健和医疗保健的变化
Benjamin D Sommers1, Munira Z Gunja2, Kenneth Finegold3
1Department of Health Policy and Management, Harvard T. H. Chan School of Public Health, and Brigham and Women's Hospital, Boston, Massachusetts2Office of the Assistant Secretary for Planning and Evaluation, US Department of Health and Human Services, Wash.
JAMA
|July 29, 2015
概括
"负担得起的医疗法案" (ACA) 改善了美国成年人的医疗保险覆盖,医疗服务和整体健康状况. 与没有扩张的州相比,医疗补助扩张州的低收入成年人收益更大.
科学领域:
- 卫生政策
- 公共卫生
- 医疗服务研究
背景情况:
- 可负担医疗法案 (ACA) 的目的是扩大医疗保险覆盖范围,改善美国的医疗保健服务.
- 评估ACA的影响对于了解其有效性和为未来的卫生政策提供信息至关重要.
- 前两个开放招生期提供了评估健康结果初始变化的机会.
研究的目的:
- 在ACA实施后,估计美国成年人自我报告的健康保险覆盖范围,获得护理和健康状况的全国变化.
- 为了比较居住在扩大医疗补助的州和没有扩大医疗补助的州的低收入成年人之间的变化.
主要方法:
- 2012-2015年盖洛普健康健康指数的分析,这是一个全国性的每日电话调查.
- 使用多变量回归来调整美国非老年人群的社会人口因素和ACA前趋势.
- 采用差异差异方法来比较医疗补助扩张与非扩张州的低收入成年人的结果.
主要成果:
- 在ACA后的保险覆盖,私人医生,药物获取,负担能力和整体健康状况均有显著改善.
- 包括拉丁裔成年人在内的少数群体的覆盖率增长尤为明显.
- 与未扩张州相比,医疗补助扩张州的低收入成年人无保险率下降并获得医疗保健的改善.
结论:
- ACA最初的开放入学期与医疗保险覆盖率和医疗服务获得率的显著积极趋势有关.
- 医疗补助的扩张在改善低收入人口的健康状况方面发挥了关键作用.
- 这些发现凸显了美国医疗保健法案在改善医疗保健准入和负担能力方面的作用.
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