在联邦强制医疗保险覆盖之前和之后,围产期心理治疗的使用和成本
Kara Zivin1,2,3, Xiaosong Zhang3, Anca Tilea3
1Center for Clinical Management Research, Veterans Affairs Ann Arbor Healthcare System, Ann Arbor, Michigan.
JAMA network open
|August 9, 2024
概括
心理健康平等和成公平法案 (MHPAEA) 和"负担得起的医疗法案" (ACA) 增加了为分娩妇女使用心理治疗,特别是那些患有围产期情绪和焦虑障碍 (PMAD) 的妇女. 这些法律还减少了心理健康治疗的自付费用.
科学领域:
- 医疗服务研究 医疗服务研究
- 卫生经济学 卫生经济学
- 心理健康政策 心理健康政策
背景情况:
- 保险覆盖面对患有围产期情绪和焦虑障碍 (PMADs) 的妇女获得医疗保健有重大影响.
- 心理健康平等和成公平法案 (MHPAEA) 和患者保护和负担得起的医疗法案 (ACA) 是为了改善医疗保健准入而颁布的.
研究的目的:
- 评估MHPAEA和ACA的实施与心理治疗的利用和成本之间的关联.
- 专门研究这些协会在分娩妇女,无论是整体和那些被诊断为PMADs.
主要方法:
- 采用从2007年到2019年的私人保险数据中断时间序列分析的横截面研究.
- 分析的重点是心理治疗访问和自付费用 (OOPC) 在分娩前后的一年.
- 检查了与MHPAEA (2010年1月实施) 和ACA (2014年1月实施) 立法相关的变化.
主要成果:
- ACA与分娩妇女每月使用心理治疗的显著增加有关.
- 对于患有PMAD的女性来说,MHPAEA和ACA都与接受心理治疗的立即增加有关,在ACA后观察到持续的每月增加.
- 每次访问心理治疗OOPCs在MHPAEA之后下降,并显示出最初的增加,然后在ACA实施后稳定地每月增加.
结论:
- MHPAEA和ACA有复杂但互补的关联,用于为分娩妇女提供心理治疗.
- 调查结果强调了持续努力的重要性,以提高心理健康治疗这一群体的可访问性.
- 像MHPAEA和ACA这样的政策干预表明了改善精神卫生保健利用率和负担能力的潜力.
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