在"负担得起的护理法案"之前和之后,对抑郁症治疗的未满足需求
Daniel Hagen1,2,3,4,5, Emily Goldmann6,7, Rebecca M Schwartz8,9,10,11,12
1Northwell, New Hyde Park, NY, USA. dhagen1@northwell.edu.
Social psychiatry and psychiatric epidemiology
|September 24, 2025
概括
负担得起的医疗法案 (ACA) 减少了对抑郁症治疗的未满足需求,尽管抑郁症仍然很普遍. 进一步的政策变化可能会改善心理健康公平.
科学领域:
- 公共卫生 公共卫生
- 医疗保健服务研究 医疗服务研究
- 心理健康政策 心理健康政策
背景情况:
- 负担得起的医疗保健法案 (ACA) 的目的是扩大获得医疗保健服务的机会,包括心理健康.
- 了解ACA对未满足抑郁症治疗需求的影响对于公共卫生政策至关重要.
- 之前的研究还没有充分探讨ACA实施后的心理健康平等变化.
研究的目的:
- 检查"负担得起的医疗法案" (ACA) 实施后抑郁症治疗未满足需求的变化.
- 评估公众心理健康公平性与ACA后的抑郁症护理准入有关.
- 分析未经治疗的抑郁症症状的趋势,根据各种人口和医疗保健因素分层分层.
主要方法:
- 利用了来自3522名国家健康和营养检查调查 (NHANES) 受访者 (2005-2020) 的数据.
- 采用修改后的Poisson回归模型来比较ACA前 (2005-2010) 和ACA后 (2013-2020) 的时间段.
- 对抑郁症治疗的未满足需求进行分析,对共变量进行调整,并根据社会人口统计和医疗保健变量进行分层.
主要成果:
- 总体而言,抑郁症治疗的未满足需求在ACA后从56%降至47%.
- 这意味着在对共变量进行调整后,未满足需求减少了14% (PR 0.86).
- 显著的减少主要在医疗保险受益者和在前一年使用过医疗保健服务的人群中观察到.
结论:
- ACA与未满足的抑郁症治疗需求的减少有关,但仍然存在重大需求.
- 建议消除对初级保健访问的障碍,并实施普遍查政策.
- 需要进一步的干预措施来改善心理健康公平,并减少未经治疗的抑郁症的负担.
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