Pagán José A, Pauly Mark V
Department of Economics and Finance, College of Business Administration, The University of Texas-Pan American, 1201 W. University Dr., Edinburg, TX 78541, USA.
Health Serv Res. 2006 Jun;41(3 Pt 1):788-803. doi: 10.1111/j.1475-6773.2006.00506.x.
To examine the relationship between community-level uninsurance rates and the self-reported unmet medical needs of insured and uninsured adults in the U.S.
2000-2001 Community Tracking Study, which includes data from 60 randomly selected U.S. communities. The sample is representative of the contiguous U.S. states.
Multilevel logistic regressions were employed to investigate whether the local uninsurance rate was related to having reported unmet medical needs within the last year. The models also included individual and community variables that could be potentially related to both community uninsurance rates and having reported unmet medical needs.
The community uninsurance rate was positively associated with having reported unmet medical needs, but only for insured adults. On average, a five percentage point increment in the local uninsured population is associated with a 10.5 percent increase in the likelihood that an insured adult will report having unmet medical needs during the 12-month period studied.
Local health care delivery systems seem to be negatively affected by high uninsurance rates. These effects could have negative consequences for health care access, even for individuals who are themselves insured.
探讨美国社区层面的未参保率与参保及未参保成年人自我报告的未满足医疗需求之间的关系。
2000 - 2001年社区追踪研究，其中包含从美国60个随机选取社区收集的数据。该样本代表了美国毗连各州。
采用多水平逻辑回归分析来研究当地未参保率是否与过去一年中报告的未满足医疗需求相关。模型还纳入了可能与社区未参保率及报告的未满足医疗需求均相关的个体和社区变量。
社区未参保率与报告的未满足医疗需求呈正相关，但仅针对参保成年人。平均而言，当地未参保人口比例每增加5个百分点，参保成年人在研究的12个月期间报告有未满足医疗需求的可能性就增加10.5%。
当地医疗服务提供系统似乎受到高未参保率的负面影响。这些影响可能对医疗服务可及性产生负面后果，即使对于那些本身参保的个体也是如此。
