Escarce José J, Kapur Kanika
RAND Health Program, David Geffen School of Medicine at UCLA, USA.
Milbank Q. 2003;81(2):249-75, 172. doi: 10.1111/1468-0009.t01-1-00053.
This study examines the current allocation of medical care expenditures among non-Hispanic white, non-Hispanic black, and Hispanic seniors who are Medicare beneficiaries. Analyses of both "need-based" and "demand-based" perspectives found that white, black, and Hispanic seniors in similar health had similar total annual expenditures for medical care. The groups did, however, differ substantially in the distribution of expenditures between public and private sources of payment. Notably, racial and ethnic differences in public and private expenditures all but vanished when socioeconomic variables and health insurance coverage were included in the analyses. The findings suggest that public sources of payment for medical care services, especially public supplementary coverage have helped to eliminate racial and ethnic gaps in expenditures.
本研究考察了作为医疗保险受益人的非西班牙裔白人、非西班牙裔黑人以及西班牙裔老年人当前的医疗保健支出分配情况。从“基于需求”和“基于需求”的角度进行分析发现,健康状况相似的白人、黑人和西班牙裔老年人每年的医疗保健总支出相似。然而,这些群体在公共和私人支付来源之间的支出分配上存在很大差异。值得注意的是,当分析中纳入社会经济变量和医疗保险覆盖范围时,公共和私人支出方面的种族和族裔差异几乎消失了。研究结果表明,医疗保健服务的公共支付来源,尤其是公共补充保险,有助于消除支出方面的种族和族裔差距。