种族和民族差异在出口袋支出的产妇护理支出
Rebecca A Gourevitch1, Jessica L Cohen2, Tara Shakley3
1Department of Health Policy and Management, University of Maryland, College Park.
JAMA health forum
|February 28, 2025
概括
由于共同保险,黑人和西班牙裔个人面临更高的产妇护理费用,这可能会影响医疗保健的获取. 健康计划的调整可以促进更大的支出公平.
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:
- 孕产妇医疗保健的自费费 (OOP) 费用上升可能会对医疗保健利用率和患者的治疗结果产生负面影响.
- 关于孕产妇健康状况的种族和民族差异已经得到了充分的证据,但相关支出方面的差异仍然不太了解.
研究的目的:
- 量化不同种族和种族群体在具有商业保险的个人中对OOP产妇护理支出的差异.
主要方法:
- 一个回顾性横截面分析利用了马萨诸塞州蓝十字蓝盾 (2018-2022) 的行政数据.
- 该研究检查了整个孕产期 (怀孕,分娩,产后42天) 的OOP支出,按种族和民族分层.
- 分析了总体支出,按时期 (产前,分娩),按成本共享类型,以及人口普查中位收入的百分比.
主要成果:
- 这项研究包括了87,253次孕产期. 黑人 (2398美元) 的平均OOP支出最高,其次是西班牙裔 (2300美元),亚裔 (2202美元) 和白人 (2036美元) 个人 (P <.001).
- 在调整了健康和人口因素后,这些支出差异仍然存在,在产前期观察到的最大差异归因于共同保险.
- 与亚洲人和白人相比,黑人和西班牙裔个人更有可能拥有高共同保险率的计划.
结论:
- 商业保险人员在OOP产妇支出中的差异与共同保险费率的变化有关.
- 这些财务负担可能会迫使个人放弃基本的医疗保健或其他基本需求.
- 建议对健康计划福利设计进行修改,以提高OOP产妇支出的公平性,并减轻不利后果.
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