分配权利:医疗补助长期护理计划中的行政负担
Pamela Herd1, Rebecca A Johnson2
1University of Michigan.
Journal of health politics, policy and law
|September 27, 2024
概括
各州通过官僚障碍为社区服务分配医疗补助豁免. 这些行政负担,包括等待名单和令人困惑的流程,不成比例地影响寻求基本支持的边缘化残疾人.
科学领域:
- 公共卫生 公共卫生
- 医疗保健服务研究 医疗服务研究
- 关于残疾人的研究.
背景情况:
- 医疗补助豁免为残疾人提供基于社区的支持,作为制度化的替代方案.
- 豁免计划不是权利,这意味着资格不保证服务.
- 国家采用官僚程序来管理和限制这些有条件权利的获取.
研究的目的:
- 分析各州如何使用行政程序来分配获得医疗补助家庭和社区服务的机会.
- 调查符合条件的残疾人被拒绝或延迟获得豁免计划的机制.
主要方法:
- 对州医疗补助豁免计划的初级和二级数据的分析.
- 影响服务获取的国家行政程序的文件.
主要成果:
- 复杂的豁免计划造成间接负担,增加成本并阻碍资格.
- 直接配给是通过等候名单和优先考虑符合条件的个人进行的.
- 不透明的行政流程和负担不成比例地影响边缘化群体,隐藏配给策略.
结论:
- 行政负担阻碍了残疾人根据ADA生活在社区中的权利.
- 豁免计划的不透明度有助于隐藏配给,导致不平等.
- 官僚程序有效地管理访问,同时掩盖服务限制的根本原因.
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