在COVID-19大流行期间持续的医疗补助资格和产后覆盖,医疗保健和结果
Jamie R Daw1, Colleen L MacCallum-Bridges2, Katy B Kozhimannil3
1Department of Health Policy and Management, Columbia University Mailman School of Public Health, New York, New York.
在COVID-19公共卫生紧急情况 (PHE) 期间,持续的医疗补助资格显著减少了那些医疗补助支付分娩的人的产后无保险. 然而,它没有影响医疗保健使用,母乳养或抑郁症状.
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
- 孕产妇健康 孕产妇健康
背景情况:
- 家庭首要应对冠状病毒法案 (FFCRA) 在COVID-19公共卫生紧急情况 (PHE) 中延长了连续的医疗补助资格超过分娩后60天.
- 这一政策实际上创造了产后医疗补助覆盖范围的全国扩展.
- 了解这一延期对孕产妇健康结果的影响至关重要.
研究的目的:
- 评估持续的医疗补助资格和产后医疗保险,医疗保健利用,母乳养和抑郁症状之间的关联.
- 评估延长产后医疗补助覆盖范围对孕产妇健康指标的影响.
主要方法:
- 一项队列研究使用了通用差异差异设计.
- 包括21个州使用来自2017-2021年怀孕风险评估监测系统 (PRAMS) 的数据.
- 检查了FFCRA后的医疗补助收入资格门 (以联邦贫困水平的百分比) 的变化.
主要成果:
- 对于产后医疗补助资格的联邦贫困水平 (FPL) 的100%增加与医疗补助入学人数增加5.1个百分点有关.
- 无保险人数下降了6.6个百分点,在医疗补助支付分娩的人群中减少了40%.
- 在非西班牙裔白人和黑人个人中观察到无保险的减少,但在西班牙裔个人中没有. 医疗保健访问,避孕措施使用,母乳养或抑郁症状没有变化.
结论:
- 在COVID-19期间,持续的医疗补助资格PHE显著减少了医疗补助支付分娩的个人产后无保险.
- 该政策没有证明与产后访问,避孕措施使用,母乳养或产后4个月抑郁症状的相关性.
- 研究结果表明,延长产后医疗补助资格有潜在的好处,需要进一步研究长期影响和更广泛的政策影响.
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