社会风险因素,医疗保险覆盖范围和获得护理的不平等
Kevin H Nguyen1, Megan B Cole1
1Department of Health Law, Policy, and Management, Boston University School of Public Health, Boston, Massachusetts.
社会风险因素 (SRF) 显著恶化了低收入成年人获得医疗保健的机会. 更多的SRF增加了负担不起的护理的可能性,并降低了私人医生或例行检查的机会.
科学领域:
- 健康的社会决定因素
- 医疗保健服务研究 医疗服务研究
- 健康 公平 卫生 公平
背景情况:
- 社会风险因素 (SRF) 与获得医疗保健的机会较差有关.
- 了解SRF对弱势群体的流行和影响对于健康公平至关重要.
- 低收入的成年人往往面临严重的护理障碍.
研究的目的:
- 为了确定低收入成年人中SRF的患病率.
- 评估SRF数量与获得医疗保健之间的关系.
- 检查这种关系是如何根据医疗保险类型而异的.
主要方法:
- 利用了来自39个州的2022行为风险因素监测系统数据.
- 分析了90,208名低收入成年人.
- 采用多变量线性概率模型来评估SRF与获得护理措施之间的关联,按保险类型分层 (私人,医疗保险,医疗补助,无保险).
主要成果:
- 46.6%的低收入成年人报告至少有一个SRF.
- 拥有四个或更多SRF的个人更有可能面临与成本相关的护理障碍 (28.21 PP增加),并且不太可能有个人医生 (-4.98 PP) 或例行检查 (-4.29 PP).
- 与医疗保险或医疗补助相比,私人保险和无保险人群中,SRF对成本相关的进入障碍的影响更为明显.
结论:
- 增加的社会风险因素与低收入人群获得护理的机会减少密切相关.
- 解决与成本相关的障碍,实施医疗服务改革,制定针对SRF的社会政策,对于改善医疗保健准入至关重要.
- 针对性干预可能是必要的,以减轻SRF对特定保险集团的不成比例影响.
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