Mold James W, Fryer George E, Thomas Cynthia H
Department of Family and Preventive Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma 73104, USA.
J Am Geriatr Soc. 2004 Apr;52(4):601-6. doi: 10.1111/j.1532-5415.2004.52169.x.
Because of the Medicare program, a common assumption is made that virtually all older Americans have health insurance coverage. Data from the 2000 National Health Interview Survey were analyzed to estimate the number of people aged 65 and older without health insurance; their stated reasons for being uninsured; and the associations between lack of insurance and sociodemographic variables, health status, and access to and use of healthcare services. In 2000, there were approximately 350,000 older Americans with no health insurance. Those without insurance were more likely to be younger, Hispanic, nonwhite, unmarried (widowed, divorced, or never married), poor, and foreign-born. They were less likely to hold U.S. citizenship. Despite relatively high rates of chronic medical conditions, they were unlikely to receive outpatient or home healthcare services. The most common reason given for lack of insurance was its cost. This study reveals important gaps in the availability of health insurance for the elderly, gaps that are likely to affect an increasing number of older Americans in the coming decade.
由于医疗保险计划，人们普遍认为几乎所有美国老年人都有医疗保险。对2000年全国健康访谈调查的数据进行了分析，以估计65岁及以上未参加医疗保险的人数；他们表示未参保的原因；以及未参保与社会人口统计学变量、健康状况以及获得和使用医疗服务之间的关联。2000年，约有35万美国老年人没有医疗保险。未参保者更有可能是年轻人、西班牙裔、非白人、未婚（丧偶、离异或从未结婚）、贫困以及外国出生的人。他们拥有美国公民身份的可能性较小。尽管慢性病发病率相对较高，但他们不太可能接受门诊或家庭医疗服务。未参保最常见的原因是费用问题。这项研究揭示了老年人医疗保险覆盖方面的重要差距，这些差距在未来十年可能会影响越来越多的美国老年人。
