Zuvekas S H, Weinick R M
Center for Cost and Financing Studies, Agency for Health Care Policy and Research, Rockville, MD 20852, USA.
Health Serv Res. 1999 Apr;34(1 Pt 2):271-9.
To describe changes in Americans' access to care over the last 20 years focusing on the uninsured, Hispanic American, and young adult populations, and to analyze the factors underlying these changes with a particular focus on the role of health insurance.
DATA SOURCES/STUDY SETTING: Data from the 1977 National Medical Care Expenditure Survey, the 1987 National Medical Expenditure Survey, and the 1996 Medical Expenditure Panel Survey.
Focusing on whether each individual has a usual source of health care, we present descriptive statistics and algebraic decompositions.
DATA COLLECTION/EXTRACTION METHODS: We combine data from the household surveys with questions from access to care supplements that were administered each time.
Hispanic Americans and young adults age 18-24 are more likely to lack a usual source of care than other Americans; these inequalities increased over the period studied and cannot be explained solely by changes in health insurance coverage.
Although increasing health insurance coverage will likely improve access to care among Hispanics and young adults, our findings suggest that the expansion of insurance coverage will not be sufficient to eliminate current disparities in access to care.
描述过去20年美国人获得医疗服务情况的变化，重点关注未参保人群、西班牙裔美国人以及年轻成年人，并分析这些变化背后的因素，特别关注医疗保险的作用。
数据来源/研究背景：来自1977年全国医疗保健支出调查、1987年全国医疗支出调查以及1996年医疗支出小组调查的数据。
聚焦于每个人是否有常规的医疗保健来源，我们呈现描述性统计数据和代数分解。
数据收集/提取方法：我们将家庭调查数据与每次进行的医疗服务可及性补充调查中的问题相结合。
西班牙裔美国人以及18 - 24岁的年轻成年人比其他美国人更有可能没有常规的医疗服务来源；在研究期间，这些不平等现象有所加剧，且不能仅通过医疗保险覆盖范围的变化来解释。
尽管扩大医疗保险覆盖范围可能会改善西班牙裔和年轻成年人获得医疗服务的情况，但我们的研究结果表明，保险覆盖范围的扩大不足以消除目前在获得医疗服务方面的差距。
