美国预防性护理意外成本共享的不平等现象
Alex Hoagland1, Olivia Yu2, Michal Horný3
1Institute of Health Policy, Management, and Evaluation, University of Toronto, Toronto, Canada.
预防性护理的意外自付费用不成比例地影响受教育程度较低的患者. 这些由人口统计和健康的社会决定因素影响的成本分担差异可能会阻碍平等获得基本卫生服务.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 卫生经济学 卫生经济学
- 健康 公平 卫生 公平
背景情况:
- 预防性服务的意外自付费用 (OOP) 可以减少未来的医疗保健利用率.
- 患者人口统计和健康的社会决定因素 (SDOH) 影响了成本共享,可能会在获得护理方面造成差异.
- 了解这些差异对于解决预防性护理采用的不平等问题至关重要.
研究的目的:
- 检查患者人口统计和OOP成本之间的关联,用于共同的预防性服务.
- 确定教育和收入等因素与预防性护理成本共享的关系.
- 调查意外医疗费用的潜在差异.
主要方法:
- 一项跨部门研究分析了2017-2020年预防性服务的国家保险索赔.
- 调整为服务类型,保险,位置和时间趋势的回归分析.
- 这项研究包括了超过100万个人的170万次预防性护理接触.
主要成果:
- 40.3%的预防性护理遭遇导致了OOP成本.
- 受教育程度较低的患者承担OOP成本的几率更高.
- 低收入患者承担OOP成本的几率较低,但在发生成本时支付更多费用. 还观察到显著的种族/民族差异.
结论:
- 根据患者的人口统计数据,OOP预防护理的成本有很大差异.
- 这些成本差异可能导致人们无法公平地获得高价值的预防服务.
- 解决与人口相关的成本差异对于促进健康公平至关重要.
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