医疗保险受益人的就医障碍。

Murray L A, Poisal J A

Office of Strategic Planning, U.S. Health Care Financing Administration, USA.

Health Care Financ Rev. 1998 Spring;19(3):101-4.

This article provides information on duration of enrollment and utilization under children's health insurance programs for States planning to expand such programs in response to the Balanced Budget Act of 1997. Using data from children's health insurance programs in Pennsylvania, we find that there is a significant turnover among enrollees and the pattern of use following enrollment suggests considerable pent-up demand for medical services. The annual payment per child for services with a comprehensive benefit package in 1994-95 was estimated to range from $500 to $600 depending on turnover, which is a slight underestimation because some hospitalized children were shifted to Medicaid.

本文为计划根据1997年《平衡预算法案》扩大儿童健康保险计划的各州，提供了有关参保期限和使用情况的信息。利用宾夕法尼亚州儿童健康保险计划的数据，我们发现参保者中有显著的人员更替，参保后的使用模式表明对医疗服务存在相当大的潜在需求。1994 - 1995年，根据人员更替情况，为儿童提供综合福利套餐服务的年支付费用估计在500美元至600美元之间，由于一些住院儿童被转到了医疗补助计划，这一估计略有低估。