Solotaroff Rachel, Devoe Jennifer, Wright Bill J, Smiths Jeanene, Boone Janne, Edlund Tina, Carlson Matthew J
Portland Veterans Affairs Medical Center, 3710 SW US Veterans Hospital Road, Portland, OR 97207, USA.
Chronic Illn. 2005 Sep;1(3):191-205. doi: 10.1177/17423953050010030301.
To describe the impacts of recent Oregon Health Plan (OHP) policy changes on individuals living with chronic illness in Oregon.
A mail survey was conducted of 1374 OHP beneficiaries who were directly affected by the new policies. The analyses reported in this article represent baseline findings from the first of three survey waves in an ongoing prospective cohort study.
A significant association was found between Medicaid policy changes and high rates of disenrolment from the OHP. Compared to the non-chronically ill, the chronically ill were more likely to report inability to pay for medications, higher medical debt, more unmet health needs, and poorer health status. Among the chronically ill, those who lost insurance reported decreased access to and utilization of healthcare, more medical debt, and more restriction of medications.
As policy-makers restructure public programmes to accommodate tight budgets and rising healthcare costs, people with chronic illness can easily be overlooked. Chronically ill individuals face disproportionate financial and health burdens. Small cost-saving policy changes can lead to widespread disenrolment that cascades into reduced access to healthcare services, altered utilization patterns, and financial strain.
描述俄勒冈州医疗计划（OHP）近期政策变化对俄勒冈州慢性病患者的影响。
对1374名直接受新政策影响的OHP受益人进行了邮件调查。本文所报告的分析结果代表了一项正在进行的前瞻性队列研究中三轮调查中第一轮的基线调查结果。
发现医疗补助政策变化与OHP的高退保率之间存在显著关联。与非慢性病患者相比，慢性病患者更有可能报告无力支付药物费用、医疗债务更高、更多未满足的健康需求以及健康状况更差。在慢性病患者中，那些失去保险的人报告称获得和利用医疗保健的机会减少、医疗债务增加以及药物使用受到更多限制。
随着政策制定者重组公共项目以适应预算紧张和医疗成本上升的情况，慢性病患者很容易被忽视。慢性病患者面临着不成比例的经济和健康负担。微小的节省成本的政策变化可能导致广泛的退保，进而引发获得医疗服务的机会减少、使用模式改变以及经济压力。
