了解种族对医疗保险优势登记的影响
Adam Atherly1, Roger Feldman2, Eline van den Broek-Altenburg3
1Department of Health Administration, College of Health Professions, Virginia Commonwealth University, Richmond, Virginia, USA.
Health services research
|March 14, 2025
概括
由于偏好和属性不同,种族少数群体的医疗保险优势 (MA) 注册率更高. 黑人受益者 黑人受益者
科学领域:
- 卫生经济学 卫生经济学
- 医疗保健服务研究 医疗服务研究
- 在医疗保健中的种族差异.
背景情况:
- 与传统医疗保险 (TM) 相比,在种族少数群体中,医疗保险优势 (MA) 的入学率不成比例地高.
- 了解这种差异的驱动因素对于公平获得医疗保健和政策制定至关重要.
研究的目的:
- 调查医疗保险优势 (MA) 在种族少数群体受益人中比白人受益人更高的市场份额背后的原因.
- 将种族群体之间的MA入学率差异分解为与受益者属性和偏好相关的因素.
主要方法:
- 使用Probit模型来估计黑人和西班牙裔受益人与白人受益人之间MA和TM的选择.
- 应用了非线性Oaxaca-Blinder分解来区分基于属性和基于偏好的招生差异解释.
- 2020年医疗保险当前受益者调查 (MCBS) 的数据与县级的MA计划支付,星级评级和市场竞争数据相结合.
主要成果:
- 对于黑人受益者来说,与白人受益者相比,MA入学差异的83%是由于偏好,而17%是由于属性.
- 对于西班牙裔受益者来说,72%的MA入学差异是由属性解释的,28%是由偏好解释的.
- 关键属性包括市场特征 (支付水平) 和个人因素 (年龄,健康状况). 偏好与行业特点相关,如支付率和计划可用性.
结论:
- 黑人受益者中更高的MA入学率主要是由偏好的差异驱动的,而对于西班牙裔受益者来说,属性起着更大的作用.
- 对MA计划特征的偏好差异显著导致黑人和西班牙裔受益人的入学率更高.
- 影响MA支付率的政策变化可能会对种族少数群体产生不成比例的影响,强调需要进一步研究这些偏好差异的起源.
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