确保拉丁裔人免受疾病成本的影响
R B Valdez1, H Morgenstern, R Brown
1Department of Health Services, UCLA School of Public Health 90024-1772.
JAMA
|February 17, 1993
概括
拉丁裔在美国面临的无保险率最高 医疗改革策略可以改善覆盖范围,但由于独特的人口和经济因素,许多拉丁裔可能仍然缺乏保险.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 卫生政策 卫生政策
- 卫生社会学 卫生社会学
背景情况:
- 与美国其他族群相比,拉丁裔在医疗保险覆盖率上经历了最显著的差异.
- 了解这种覆盖差距的决定因素对于有效的卫生政策至关重要.
- 以前的研究表明,少数群体在获得医疗保健方面存在持续的不平等.
研究的目的:
- 分析影响美国拉丁裔医疗保险覆盖的因素.
- 评估各种医疗改革战略对拉丁裔覆盖率的影响.
- 评估这些改革对更广泛的美国民族景观的影响.
主要方法:
- 利用了1980年和1990年当前人口调查的数据.
- 非老年拉丁裔 (65岁以下) 与非西班牙裔白人 (Anglos),黑人和亚洲人的保险状况比较.
- 改革战略的共变量和模拟效应的估计归因分数.
主要成果:
- 拉丁裔的无保险率最高 (39%),相比之下,格鲁人 (13.8%) 和黑人 (24%).
- 涵盖穷人或所有工人的政策可以显著降低跨群体的无保险率,拉丁裔 (37%) 取得了显著的收益.
- 尽管有潜在的改善,拉丁裔在改革后仍预计将保持高绝对无保险率.
结论:
- 医疗补助资格,劳动力参与和家庭结构的差异对拉丁裔有独特的影响.
- 有针对性的策略,如雇主授权,付费或玩,以及医疗补助扩展,可以提高覆盖率.
- 即使有针对性的干预措施,拉丁裔人口的很大一部分可能仍然没有保险.
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