在18-64岁的成年人中通常的护理来源ACA后,2010-2017年
Sara Shahbazi1, John D Goodson2,3
1Massachusetts General Hospital, Boston, Massachusetts sshahbazi@mgh.harvard.edu.
Annals of family medicine
|September 22, 2025
概括
负担得起的医疗保健法案适度增加了通常的护理来源 (USC) 的获取,特别是对于低收入的成年人. 然而,诸如可访问性挑战之类的非金融障碍仍然存在,这表明仅仅保险的扩张不足以持续医疗保健.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 公共卫生政策 公共卫生政策
- 获得医疗保健 获得医疗保健 获得医疗保健
背景情况:
- 负担得起的医疗保健法案 (ACA) 旨在扩大医疗保险覆盖范围,并改善获得医疗保健的机会.
- 了解通常的护理来源 (USC) 的变化对于评估医疗保健获取和连续性至关重要.
- 在不同的社会经济和地理群体中,USC的差异可能存在.
研究的目的:
- 评估ACA实施对USC患病率的影响.
- 检查USC的变化是如何根据收入水平和农村-城市环境而变化的.
- 找出缺乏USC的原因的转变.
主要方法:
- 2010-2017年医疗支出小组调查 (MEPS) 数据的分析.
- 多变量回归模型用于估计USC调整后的百分比变化.
- 检查自己报告的缺乏通常的护理来源的原因.
主要成果:
- 总体而言,USC患病率略有增加,从67%上升至68%.
- 在农村 (+4.96%) 和城市 (+2.45%) 地区的低收入成年人中观察到显著的USC增长.
- 在城市高收入成年人中,USC略有下降,负担能力障碍下降,但可访问性和偏好障碍增加.
结论:
- ACA的实施导致了USC的适度改善,低收入人群的显著收益.
- 与医疗保健可访问性和个人偏好相关的持续挑战阻碍了普遍的持续护理.
- 仅靠保险的扩大,可能无法完全解决建立常规护理来源的非财务障碍.
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