Ong Janus P, Collantes Rochelle, Pitts Angela, Martin Lisa, Sheridan Michael, Younossi Zobair M
Center for Liver Diseases, Inova Fairfax Hospital, Annandale, VA 22003, USA.
J Clin Gastroenterol. 2005 Oct;39(9):826-30. doi: 10.1097/01.mcg.0000177258.95562.43.
There are no published data on the health insurance status of Hepatitis C virus (HCV)-positive individuals. To address this issue, we analyzed data from the Third National Health and Nutrition Examination Survey (NHANES III).
Individuals 18 years of age and older who participated in NHANES III were included in the study. We determined the rates of health insurance coverage according to HCV status. We also determined healthcare status and health service utilization according to health insurance status among HCV-positive persons.
HCV-positive individuals were more likely to be uninsured compared with those who were HCV-negative (29.6% vs. 12.2%, P = 0.0002). Among those with health insurance, HCV-positive individuals were more likely to have government insurance compared with those who were HCV-negative (42.9% vs. 27.6%, P < 0.005). Among HCV-positive individuals, being uninsured was associated with younger age, being unmarried, living in the South, Mexican-American race/ethnicity, and not graduating from high school. Additionally, the uninsured were less likely than their insured counterparts to identify a healthcare facility for sick or routine care, and less likely to have regular contact with a healthcare professional.
A high proportion of HCV-positive individuals are uninsured, and many HCV-positive individuals with health insurance have publicly funded insurance. This finding may have implications for access to health care and for liver-related disease outcomes in HCV-positive persons.
目前尚无关于丙型肝炎病毒(HCV)阳性个体健康保险状况的公开数据。为解决这一问题,我们分析了第三次全国健康与营养检查调查(NHANES III)的数据。
纳入了参加NHANES III的18岁及以上个体。我们根据HCV状况确定了医疗保险覆盖率。我们还根据HCV阳性者的健康保险状况确定了医疗保健状况和医疗服务利用率。
与HCV阴性个体相比,HCV阳性个体未参保的可能性更高(29.6%对12.2%,P = 0.0002)。在有医疗保险的人群中,与HCV阴性个体相比,HCV阳性个体更有可能拥有政府保险(42.9%对27.6%,P < 0.005)。在HCV阳性个体中,未参保与年龄较小、未婚、居住在南部、墨西哥裔种族/族裔以及未高中毕业有关。此外,未参保者比参保者识别用于疾病或常规护理的医疗机构的可能性更小,与医疗保健专业人员定期接触的可能性也更小。
很大一部分HCV阳性个体未参保,许多有医疗保险的HCV阳性个体拥有公共资助的保险。这一发现可能对HCV阳性个体获得医疗保健的机会以及与肝脏相关的疾病结局产生影响。