Altman B M, Cooper P F, Cunningham P J
Agency for Health Care Policy and Research, Center for Cost and Financing Studies, Rockville, MD 20852, USA.
Milbank Q. 1999;77(1):39-75, iv. doi: 10.1111/1468-0009.00124.
Families with a disabled member undergo heightened emotional and financial stress, which can arise from caring for the person with one or more disabilities over the life course or at the end of life. Because health care resources are strained by the needs of the disabled family member, nondisabled members are often limited in health care access and utilization when they are most in need of care. This analysis uses the National Medical Expenditure Survey to describe families with disabled members, based on multiple definitions of disability, and to examine health care utilization and expenditures by nondisabled family members. Indications of higher use of medical care by adult, nondisabled members of such families support the frequent reports in the literature of stress occurring in these situations. The signals of a household rationing effect for families near and at poverty levels should alert policy makers to consider the needs of the whole family when creating or modifying assistance programs.
有残疾成员的家庭承受着更大的情感和经济压力，这种压力可能源于在整个生命历程或生命末期照顾一名或多名残疾人。由于残疾家庭成员的需求使医疗资源紧张，非残疾家庭成员在最需要医疗护理时，其医疗护理的可及性和利用率往往受到限制。本分析利用国家医疗支出调查，根据多种残疾定义描述有残疾成员的家庭，并研究非残疾家庭成员的医疗护理利用情况和支出。这类家庭中成年非残疾成员更多使用医疗护理的迹象，支持了文献中关于这些情况下压力频发的报道。贫困线及接近贫困线家庭的家庭配给效应信号，应提醒政策制定者在制定或修改援助项目时考虑整个家庭的需求。
