根据县乡村和收入,医疗补助扩张对布普伦诺芬治疗利用的影响的差异:从2009年至2018年的药房数据索赔分析
Olivia K Golan1,2, Flora Sheng3, Andrew W Dick3
1NORC at the University of Chicago, Chicago, IL, United States.
负担得起的医疗保健法案医疗补助扩张增加了城市地区的布普伦诺芬使用,减少了收入差距. 然而,这种扩张并没有改善农村县的布普伦诺芬获取,凸显了有针对性的政策的必要性.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 公共卫生政策 公共卫生政策
- 药物使用障碍治疗 药物使用障碍治疗
背景情况:
- 对阿片类药物使用障碍的布普伦诺芬使用量有所增加,但在低收入和农村地区仍然有限.
- 布普伦诺啡因获取的差异仍然存在,尤其影响弱势群体.
研究的目的:
- 为了调查"平价医疗法案" (Affordable Care Act) 医疗补助扩大对布普伦诺芬启动率的影响.
- 分析这些比例如何根据县的收入水平和农村-城市状态而变化.
主要方法:
- 利用了全国范围内的IQVIA零售药房数据,从2009年至2018年.
- 采用了比较的中断时间序列框架,结合了回归不连续性和差异差异方法.
- 应用了零碎的线性估计来量化布普伦诺芬启动率的变化. 医疗补助前后扩张.
主要成果:
- 医疗补助的扩张显著增加了低收入城市县的布普伦诺非因开始.
- 在农村县的医疗补助扩张和布普伦诺芬开始使用率之间没有发现显著的关联,无论收入如何.
- 这项研究分析了376,704个县月的520多万次新的布普伦诺芬治疗事件.
结论:
- 医疗补助的扩张减少了城市地区与收入相关的差异.
- 在医疗补助扩张后,农村县没有改善对布普伦诺啡的公平获取.
- 未来的政策必须解决低收入农村地区的具体需求,以确保公平获得布普伦诺芬治疗.
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