使用和成本共享用于预防性癌症查
Nicholas Jennings1, David O Garcia1, Howard Eng1
1University of Arizona, Mel and Enid Zuckerman College of Public Health, United States.
Health policy OPEN
|June 29, 2023
概括
患者保护和负担得起的医疗法案 (ACA) 并没有增加预防性癌症查的使用,如乳房影像和子宫检查. 需要进一步的研究,以了解如何改善查的普及.
科学领域:
- 卫生政策 卫生政策
- 预防医学 预防医学
- 癌症查 癌症查
背景情况:
- 患者保护和可负担医疗法案 (ACA) 旨在改善医疗保健的可获得性和可负担性.
- 一个关键的规定是从2010年9月开始,取消了某些预防服务的成本共享,包括癌症查.
研究的目的:
- 评估美国癌症协会 (ACA) 取消成本共享对使用乳房影像,结肠镜和宫癌查的影响.
- 评估在ACA政策实施后,商业保险人预防性查率的变化.
主要方法:
- 采用了追溯的纵向准实验设计,将ACA合规计划中的个人与祖父计划中的个人 (不受到变化) 进行比较.
- 倾向性得分匹配被用来创建可比的治疗和控制组.
- 间断时间序列回归分析检查了从2007年到2014年的每月查利用率.
主要成果:
- 在ACA政策变化后,预防性乳房造影和宫癌查的利用趋势略有下降.
- 在研究期间,结肠镜检查的使用率没有显著下降.
结论:
- 美国癌症协会 (ACA) 的消除成本共享政策没有达到预期的结果,即增加预防性癌症查的利用率.
- 进一步调查患者教育关于在入学时的成本共享福利可能是必要的,以提高查的普及率.
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