Burstin H R, Swartz K, O'Neil A C, Orav E J, Brennan T A
Department of Quality Management Services, Brigham and Women's Hospital, Boston, MA 02115, USA.
Inquiry. 1998;35(4):389-97.
This study examines how changes in health insurance status affect patients and their care. Results show that, controlling for socioeconomic factors, condition, age, and urgency, patients who lost insurance and patients who changed insurance were more likely to delay seeking care within the four months after visiting an emergency department than people whose health insurance status did not change. Patients who lost coverage were more likely to report no primary care provider and were less likely to have recommended follow-up care within the four-month period. Loss of insurance also was associated with lower likelihood of vaccine use and check-ups in the prior year. The study confirms that a loss or change in health insurance in the prior year has a measurable effect on access to health care. The greatest impact was among patients who lost insurance, though patients who changed health plans also were more likely to delay seeking care than patients whose health insurance status did not change.
本研究探讨了医疗保险状况的变化如何影响患者及其医疗护理。结果显示，在控制社会经济因素、病情、年龄和紧急程度后，失去保险的患者以及更换保险的患者比医疗保险状况未发生变化的人更有可能在就诊急诊部门后的四个月内推迟寻求医疗护理。失去保险覆盖的患者更有可能表示没有初级保健医生，并且在四个月期间接受推荐的后续护理的可能性较小。保险的丧失还与上一年疫苗接种和体检的可能性较低有关。该研究证实，上一年医疗保险的丧失或变更对获得医疗保健有可衡量的影响。影响最大的是失去保险的患者，不过更换健康保险计划的患者也比医疗保险状况未发生变化的患者更有可能推迟寻求医疗护理。
