患者对健康保险设计的看法:混合方法分析
Bridget Doherty1, Kimberly Hooks2, Ulrich Neumann1
1Johnson & Johnson, Titusville, NJ 08560, USA; uneuman1@its.jnj.com (U.N.); szona@its.jnj.com (S.Z.); lshea4@its.jnj.com (L.S.).
Journal of market access & health policy
|November 26, 2025
概括
患有慢性疾病的患者面临医疗保险带来的财务负担,影响药物负担能力,并导致债务. 需要政策解决方案来重新设计保险和更好地管理患者成本.
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
- 患者为中心的结果.
背景情况:
- 有限的以患者为中心的证据存在于医疗保险改革和患有慢性疾病的个人的经验.
- 了解患者的观点对于有效的健康保险设计至关重要.
研究的目的:
- 从慢性病患者的角度收集对健康保险设计的见解.
- 探索受益人与他们的健康保险计划的现实世界经验.
主要方法:
- 采用了混合方法的方法,包括在线调查和虚拟焦点小组.
- 参与者是美国居民,患有慢性疾病和医疗保险.
- 从2023年8月到12月收集数据,涉及146名调查受访者和29名焦点小组参与者.
主要成果:
- 虽然大多数受益者表示满意,但由于高扣除额和成本暴露,人们对处方药的负担能力提出了重大担忧.
- 财务负担不成比例地影响了低收入人群,并导致债务,治疗放弃和健康状况恶化等问题.
- 患者对自付费用的不可预测性是一个主要问题.
结论:
- 旨在重新设计医疗保险和调整慢性病患者的成本暴露的政策干预措施得到广泛支持.
- 患者的见解对于在美国建立更好地满足慢性疾病患者需求的医疗保险系统至关重要.
- 解决财务障碍对于改善对治疗的坚持和整体健康结果至关重要.
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