国家医疗补助扩展状态与低出生体重和早产相关联
Clare C Brown1, Jennifer E Moore2,3, Holly C Felix1
1Department of Health Policy and Management, University of Arkansas for Medical Sciences, Little Rock.
JAMA
|April 24, 2019
概括
医疗补助的扩大并没有显著改变总体低出生体重或早产率. 然而,与白人婴儿相比,黑人婴儿的这些结果差异较小.
科学领域:
- 公共卫生
- 医疗服务研究
- 生产周边流行病学
背景情况:
- 低出生体重和早产是婴儿健康的关键指标,
- 这些不良出生结果与增加的婴儿死亡率和长期健康问题有关.
研究的目的:
- 确定医疗补助的扩张是否影响了低出生体重和早产率.
- 评估医疗补助扩张对这些出生结果的种族和种族差异的影响.
主要方法:
- 利用美国国家卫生统计中心2011-2016年的数据,涵盖超过1500万个出生.
- 使用差异差异 (DID) 和差异差异差异 (DDD) 模型来比较医疗补助扩张州与非扩张州的结果.
- 分析了19岁及以上妇女的单生婴儿生育情况,按种族/民族分层.
主要成果:
- 与医疗补助扩张相关的早产,非常早产,低出生体重或非常低出生体重率没有显著的整体变化.
- 黑人婴儿与医疗补助扩张州的白人婴儿之间的差异在所有四个出生结果指标中都显著减少.
- 西班牙裔婴儿的相对差异没有显著变化.
结论:
- 国家医疗补助扩张与低出生体重或早产率的整体改善没有显著关联.
- 医疗补助的扩大通过减少黑人婴儿的出生结果的种族差异产生了积极的影响.
- 调查结果突出了医疗补助扩大减轻特定健康不平等的潜力, 即使整体率没有大幅变化.
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