Blewett Lynn A, Ward Andrew, Beebe Timothy J
University of Minnesota, USA.
Med Care Res Rev. 2006 Dec;63(6):663-700. doi: 10.1177/1077558706293634.
There is little consensus on what constitutes adequate health insurance coverage. The concept of a lack of adequate coverage, or underinsurance, is a matter of ongoing debate. A measure of adequate coverage is of critical importance as the nature of health insurance products evolves. Changes to health coverage include more direct out-of-pocket spending by consumers and a reduction of covered benefits. This article updates and extends an earlier review of underinsurance measurement published in 1993. We present a conceptual approach to measuring underinsurance and provide a review of the empirical findings obtained from the application of these approaches. A discussion of the limitations in the selection of a measurement approach includes a review of the extant data sources used. We recommend a national effort to develop a consistent approach to monitor changes in the economic and structural dimensions of health insurance coverage with a concerted effort to define and measure underinsurance.
对于什么构成足够的医疗保险覆盖范围，几乎没有共识。缺乏足够覆盖范围或保险不足的概念是一个持续争论的问题。随着健康保险产品性质的演变，衡量足够覆盖范围的标准至关重要。健康保险覆盖范围的变化包括消费者更多的直接自付费用以及承保福利的减少。本文更新并扩展了1993年发表的关于保险不足衡量的早期综述。我们提出了一种衡量保险不足的概念方法，并对应用这些方法获得的实证结果进行了综述。对测量方法选择中的局限性的讨论包括对现有数据源的综述。我们建议国家做出努力，制定一种一致的方法来监测医疗保险覆盖范围的经济和结构维度的变化，并共同努力定义和衡量保险不足。
