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在有逆境病史的儿童中,医疗保险覆盖范围存在差距
Chidiogo Anyigbo1,2, Emmalee Todd3, Dmitry Tumin3
1Division of General and Community Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.
Medical care research and review : MCRR
|June 17, 2023
概括
有更多不良童年经历 (ACE) 的孩子面临着更大的医疗保险不稳定性. 较高的ACE分数增加了覆盖率差距的风险,通常是由于应用问题,影响了医疗保健的获取.
科学领域:
- 儿童健康 儿童健康
- 医疗保健服务研究 医疗服务研究
- 健康的社会决定因素
背景情况:
- 医疗保险的稳定性对于儿童获得医疗保健至关重要.
- 童年不良经历 (ACE) 与各种负面健康结果有关.
- 了解ACEs对保险连续性的影响对于有针对性的干预至关重要.
研究的目的:
- 检查ACE分数与0-17岁儿童的医疗保险稳定性之间的关联.
- 确定ACE儿童医疗保险覆盖差距的原因.
- 为改善弱势儿童获得保险的政策建议提供信息.
主要方法:
- 使用具有全国代表性的多年数据库进行横截面研究.
- 在12个月内,分析了ACE分数与持续/间歇性缺乏医疗保险之间的关联.
- 调查报告的保险覆盖缺口原因.
主要成果:
- 与4+ACE儿童相比,与0ACE儿童相比,具有显著更高的半年无保险风险 (RRR:4.20).
- 较高的ACE分数与全年无保险 (RRR: 2.28) 和半年公共保险 (RRR: 1.37) 的可能性增加相关.
- 申请或更新过程中的困难更频繁地被认为是高ACE分数儿童覆盖率差距的原因.
结论:
- 儿童不良经历显著破坏了儿童的健康保险稳定性.
- 政策干预措施解决保险申请/续保中的行政负担,可能会提高ACE儿童的获取机会.
- 改善保险连续性对于确保对遭受逆境影响的儿童提供一致的医疗保健服务至关重要.
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