健康计划设计与纳洛需求之间的关联,来自纽约自然实验的证据
Christopher Dunphy1, Gaius Ahamide2, Kun Zhang1
1National Center for Injury Control and Prevention, Centers for Disease Control and Prevention.
高扣除健康计划 (HDHPs) 与较低的纳洛接收有关,这是由于州的共同处方法. 解决自付费用对于纳洛的获取和过量预防至关重要.
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
- 药物经济学 药物经济学
背景情况:
- 供应侧纳洛的获取情况有所改善,但在美国,利用率仍然很低.
- 需求方面的障碍,特别是自费成本,可能会阻碍纳洛的接收.
- 健康计划的设计可以影响患者获得纳洛等必需药物的机会.
研究的目的:
- 评估健康计划设计与纳洛接收之间的关联.
- 评估纽约州纳洛联合处方法对纳洛吸收的影响.
- 确定影响纳洛获取的潜在财务障碍.
主要方法:
- 从2021年1月到2023年3月,利用了纽约商业保险人员的行政索赔数据.
- 采用差异模型来比较法律颁布前后的纳洛共处置率.
- 在高扣除健康计划 (HDHP) 和非HDHP计划中比较个人.
主要成果:
- 这一政策变化使得在非高质量医疗者中,纳洛的共处方增加了4.6个百分点,在高质量医疗者中增加了1.3个百分点.
- 与非HDHP注册者相比,HDHP注册者在纳洛共处置的增加明显较低 (3.4个百分点的差异).
- 这表明根据保险计划类型和相关的成本共享,纳洛吸收的差异.
结论:
- 与某些保险计划相关的更高的自费费用减少了纳洛处方的履行.
- 医疗保险设计的变化会造成金融障碍,这可能会限制纳洛的获取.
- 解决需求侧金融障碍是加强过量预防工作的关键策略.
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