Cohen Robin A, Makuc Diane M, Bernstein Amy B, Bilheimer Linda T, Powell-Griner Eve
US Department of Health & Human Services, Centers for Disease Control and Prevention, National Center for Health Statistics, Division of Health Interview Statistics, Hyattsville, MD 20782, USA.
Natl Health Stat Report. 2009 Jul 1(17):1-25.
This report presents long-term trends in the number and percentage of persons under age 65 years with different types of health insurance coverage and with no coverage. It documents changes in how the National Health Interview Survey (NHIS) has collected information about coverage over almost 50 years. It also compares recent trends in coverage estimates based on the NHIS and the U.S. Census Bureau's Current Population Survey (CPS).
Estimates were derived from 32 years of the NHIS, from 1959 to 2007. The types of estimates available differ over these years, reflecting changes in the availability of different types of coverage and changes in the NHIS questions. Joinpoint regression was used to estimate average annual percent change over time and to identify statistically significant changes in trends.
The percentage of persons under age 65 years with private coverage rose between 1959 and 1968, to 79%, remained stable until 1980, and then declined to 67% by 2007. During the 1980s, the percentage of persons with no coverage increased, while the percentage with private coverage declined and the percentage with Medicaid remained stable. Since 1990, the percentage of nonelderly persons without coverage has remained stable, but the number has increased by more than 6 million persons, to 43.3 million in 2007. During this period, the percentage with private coverage has continued to decline, while the percentage with Medicaid has increased. Recent trends in coverage based on the NHIS and CPS are similar.
本报告呈现了65岁以下拥有不同类型医疗保险覆盖以及无保险覆盖人群数量和百分比的长期趋势。记录了近50年来国家健康访谈调查（NHIS）收集保险覆盖信息方式的变化。还比较了基于NHIS和美国人口普查局当前人口调查（CPS）的保险覆盖估计的近期趋势。
估计数据来自1959年至2007年的32年NHIS。这些年可用的估计类型有所不同，反映了不同类型保险覆盖的可得性变化以及NHIS问题的变化。连接点回归用于估计随时间的平均年度百分比变化，并确定趋势中的统计学显著变化。
1959年至1968年，65岁以下拥有私人保险覆盖的人群百分比上升至79%，1980年前保持稳定，到2007年降至67%。在20世纪80年代，无保险覆盖人群的百分比增加，而私人保险覆盖人群的百分比下降，医疗补助覆盖人群的百分比保持稳定。自1990年以来，非老年人无保险覆盖的百分比保持稳定，但人数增加了600多万，到2007年达到4330万。在此期间，私人保险覆盖人群的百分比持续下降，而医疗补助覆盖人群的百分比增加。基于NHIS和CPS的近期保险覆盖趋势相似。
