住院导致财务不稳定的风险:对医疗保险财政援助的目标化影响
Paula Chatterjee1, Eliza Macneal2, Syama R Patel2
1Department of Medicine, University of Pennsylvania Perelman School of Medicine, and Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, Pennsylvania (P.C., E.T.R.).
许多医疗保险受益人面临财政困难,原因是自付费用. 几乎一半的收入在贫困线的100-400%之间的人缺乏资金来支付医疗保险A部分的扣除.
科学领域:
- 卫生经济学 卫生经济学
- 老年学是一门学科.
- 公共卫生 公共卫生
背景情况:
- 医疗保险的高自付费用 (OOP) 可能会导致受益人陷入财务不稳定.
- 收入不高的受益人往往缺乏医疗补助资格,并与意外的医疗保健费用作斗争.
- 医疗保险受益人现有的财务保护是不够的,风险人群还没有明确定义.
研究的目的:
- 为了确定因医疗保险A部分医院扣除额而面临财务不稳定风险的医疗保险受益人.
- 描述因医疗保健费用而面临潜在经济困难的人口.
主要方法:
- 使用2018年健康和退休研究数据进行的横截面研究.
- 对收入在联邦贫困线100%至400%之间的社区住宿医疗保险受益人的分析.
- 基于支票/储蓄余额,有生活费储备的流动资产和补充保险覆盖的财务不稳定性的检查.
主要成果:
- 45.0%的受益人没有足够的支票/储蓄来支付1600美元的医疗保险A部分扣除.
- 在黑人和西班牙裔受益者,低教育水平者和患有多种慢性疾病的个人中,财务不稳定性更高.
- 即使在计算流动资产和补充保险后,很大一部分仍然在财务上不稳定.
结论:
- 有相当数量的低收入的医疗保险受益人很容易因为一次住院而面临经济困难.
- 该研究强调,需要在医疗保险中改善财务保护,以减轻成本共享的影响.
- 针对研究中确定的脆弱子组,可能需要针对性的干预措施.
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