Coughlin Teresa A, Long Sharon K, Shen Yu-Chu
Urban Institute, Washington, DC, USA.
Health Aff (Millwood). 2005 Jul-Aug;24(4):1073-83. doi: 10.1377/hlthaff.24.4.1073.
States have broad latitude in designing their Medicaid programs; this has important implications for access to care. To understand the consequences of state variation, we evaluate, for the nation and for thirteen study states, how well the program is providing access for beneficiaries, using the level of access available to low-income privately insured people in the local health care market as our benchmark. Overall, we find that Medicaid beneficiaries' access matches that of the low-income privately insured for most of the ambulatory outcomes examined but is worse for dental services and prescription drugs. State-level analyses revealed some variation in the access gap.
各州在设计其医疗补助计划方面有很大的自由度；这对获得医疗服务有重要影响。为了解各州差异的后果，我们以当地医疗市场中低收入私人保险人群可获得的医疗服务水平为基准，评估了全国以及13个研究州的医疗补助计划为受益人群提供医疗服务的情况。总体而言，我们发现，在大多数所考察的门诊治疗结果方面，医疗补助受益人的医疗服务可及性与低收入私人保险人群相当，但在牙科服务和处方药方面则较差。州层面的分析揭示了医疗服务可及性差距方面的一些差异。
