在有或没有复杂医疗状况的年轻成年人中退出医疗补助计划
Betsy Q Cliff1, Soham Sinha1, Dori A Cross2
1Department of Public Health Sciences, University of Chicago, Chicago, Illinois.
JAMA pediatrics
|February 16, 2026
概括
退出医疗补助计划对于年轻人来说是常见的,特别是那些患有复杂医疗状况 (CMCs) 的年轻人,在州一级有很大的差异. 在这个关键的过渡时期,覆盖率差距会增加健康风险.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 公共卫生 公共卫生
- 儿科健康 儿科健康
背景情况:
- 失去医疗补助保险对从儿童到成人医疗保健系统过渡的年轻人来说是一个重大风险.
- 患有复杂病情 (CMCs) 的个人在失去医疗保险时面临患病和死亡的风险增加.
研究的目的:
- 量化医疗补助退学风险的年轻成年人与或没有CMCs.
- 根据医疗状况和居住状态,检查退学风险的变化.
主要方法:
- 使用来自47个州的2016-2019年医疗补助行政索赔数据进行了回顾性观察性研究.
- 使用儿科医学复杂性算法识别的CMC.
- 采用离散时间生存模型和卡普兰-梅尔曲线来估计16-26岁的退学和重新入学风险.
主要成果:
- 退学率在19岁达到顶峰,有条件概率为13.4%的个人有CMC和35.6%的人没有.
- 观察到,退学风险在各州的水平上有显著的差异,在两组人群中差异很大.
- 心理健康和心脏病显示CMC中退学概率最高;收入资格和医疗补助扩展状态等因素影响了风险.
结论:
- 对于新兴成年人来说,医疗补助覆盖的中断很普遍,影响有或没有CMC的人.
- 覆盖损失因州和特定的医疗条件而异.
- 了解这些模式对于制定有针对性的干预措施至关重要,以确保弱势年轻人的持续医疗保险.
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