医疗补助扩张和可预防的紧急部门使用根据种族/种族
Megan B Cole1, Braden W Strackman2, Karen E Lasser3
1Department of Health Law, Policy, and Management, Boston University School of Public Health, Boston, Massachusetts.
负担得起的医疗保健法案 (Medicaid) 的扩张并没有改变对门诊护理敏感条件 (ACSCs) 的急诊室访问. 然而,除了加利福尼亚州,它减少了ACSC的访问量和份额,特别是在白人成年人中.
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
- 健康差异 在健康上的差异
背景情况:
- 负担得起的医疗法案 (ACA) 在2014年扩大了医疗补助资格.
- 门诊护理敏感条件 (ACSCs) 可以通过适当的门诊护理来预防.
- 在获得和利用医疗保健方面存在种族和民族差异.
研究的目的:
- 检查 ACA 医疗补助扩张对 ACSC 紧急诊所 (ED) 访问的影响.
- 根据种族/种族 (黑人,西班牙裔,白人) 和保险状况分析ACSC ED访问的变化.
- 评估医疗补助扩张对ACSC ED访问率和份额的影响.
主要方法:
- 利用了来自九个扩张州和五个非扩张州的2010-2018年排放数据.
- 采用事件研究差异差异回归模型.
- 每100名成年人每年的ACSC ED访问量和ACSC ED访问份额的估计变化.
主要成果:
- 医疗补助扩张显示,ACSC ED率整体或按种族/种族而言没有显著变化.
- 除了加利福尼亚州,扩张与ACSCEDED率和种族/民族群体的份额下降有关.
- 白人成年人经历了ACSC ED率和份额的最大降低.
结论:
- 医疗补助的扩张表明,一些州的ACSC ED率下降,ACSC ED总体份额下降.
- 需要采取政策努力,将新获得保险的个人,特别是黑人和西班牙裔患者,与门诊护理联系起来.
- 扩大初级保健能力和有针对性的外展可以帮助缓解ACSCC ED访问中的差异.
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