在COVID-19大流行之前和期间,医疗补助入学和支出的差异
Nianyi Hong1, Noelia Duchovny1, Ru Ding1
1Congressional Budget Office, Washington, DC.
JAMA network open
|June 18, 2025
概括
由于COVID-19大流行和持续的资格政策,医疗补助计划的入学人数保持不变,但支出减少,新入学者的支出持续较低. 关键的护理可能因为不完全的支出回收而被推迟.
科学领域:
- 公共卫生 公共卫生
- 卫生政策 卫生政策
- 卫生经济学 卫生经济学
背景情况:
- "COVID-19"大流行严重影响了医疗保健的准入和覆盖范围.
- 在疫情期间实施了医疗补助持续资格政策.
- 了解对医疗补助入学和支出的长期影响对于政策决策至关重要.
研究的目的:
- 为了比较大人和儿童在COVID-19大流行之前和期间的Medicaid入学和支出模式.
- 评估持续的资格政策对医疗补助覆盖的影响.
- 通知决策者关于与大流行相关的医疗补助改革的长期后果.
主要方法:
- 使用转型医疗补助统计信息系统 (T-MSIS) 的行政数据,采用了一个队列研究设计.
- 在18个月的时间里,两组医疗补助入学者 (2018年2月和2020年2月) 进行了比较.
- 分析了来自25个州和哥伦比亚特区的入学和支出数据.
主要成果:
- 持续的资格政策增加了28%的成年人和19%的儿童在18个月后的医疗补助入学.
- 与大流行前队列相比,大流行队列的医疗补助支出平均较低,特别是在最初的封锁期间.
- 与现有招生人群相比,新加入的流行病队伍的支出显著降低 (44%-58%),即使在18个月后,支出仍低于流行病前的水平.
结论:
- 医疗补助持续资格政策在疫情期间有效地维持了入学率.
- 根据这些政策的新入学者支出大幅降低,这表明可能推迟基本护理.
- 这些发现强调需要仔细考虑政策对医疗保健利用和获取的影响.
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