Bennett Kevin J, Dismuke Clara E
Department of Family and Preventive Medicine, University of South Carolina School of Medicine, Columbia, SC 29203, USA.
J Health Care Poor Underserved. 2010 May;21(2):691-703. doi: 10.1353/hpu.0.0309.
High out-of-pocket expenditures for health care can put individuals and families at financial risk. Several groups, including racial/ethnic minority groups, the uninsured, rural residents, and those in poorer health are at risk for this increased burden.
The analysis utilized 2004-2005 MEPS data. The dependent variables were the out-of-pocket health care spending to total income ratios for total spending, office-based visits, and prescription drugs. Multivariate analyses with instrumental variables controlled for respondent characteristics.
Gender, age, rurality, insurance coverage, health status, and health care utilization were all associated with higher out-of-pocket to income ratios.
Certain groups, such as women, the elderly, those in poor health, and rural residents, are at a greater financial risk due to their higher out-of-pocket to total income spending ratios. Policymakers must be aware of these increased risks in order to provide adequate resources and targeted interventions to alleviate some of this burden.
高额的医疗自付费用会使个人和家庭面临经济风险。包括少数种族/族裔群体、未参保者、农村居民以及健康状况较差的人群在内的几个群体都面临着这种负担加重的风险。
该分析使用了2004 - 2005年医疗支出面板调查(MEPS)数据。因变量是自付医疗费用占总收入的比例,分别针对总支出、门诊就诊和处方药支出进行计算。采用工具变量进行多变量分析,以控制受访者特征。
性别、年龄、农村地区、保险覆盖情况、健康状况以及医疗服务利用情况均与较高的自付收入比相关。
某些群体,如女性、老年人、健康状况较差者以及农村居民,因其较高的自付费用占总收入的支出比例,面临更大的经济风险。政策制定者必须意识到这些增加的风险,以便提供足够的资源和有针对性的干预措施来减轻部分负担。