New England Research Institutes, Inc., Watertown, MA 02472, USA.
Int J Health Serv. 2010;40(3):507-23. doi: 10.2190/HS.40.3.g.
This article examines the sociodemographic and health characteristics of the underinsured-people who have some health insurance but are having trouble paying for health care or medications. It uses data from the Boston Area Community Health (BACH) Survey, a large (N=5503) community-based random sample of Boston residents aged 30 to 79 years (1767 black, 1,877 Hispanic, and 1859 white; 2301 men and 3202 women). The authors found that minorities were less likely than whites to have health insurance (for men and women, respectively, 30% and 19% of Hispanics, 16% and 9% of blacks, and 9% and 7% of whites lacked health insurance). Blacks were the most likely to be underinsured (for men and women, respectively, 18% and 20% of blacks vs. 9% and 14% of Hispanics and 8% and 12% of whites were underinsured). Those of lower and middle socioeconomic status were also more likely to be uninsured or underinsured. The health status of the uninsured was similar to that of the adequately insured, whereas those who were underinsured reported more co-morbidities and depression. The underinsured are generally older and sicker, and make greater use of the health care system, and may present a larger public health and health policy challenge than the uninsured.
这篇文章探讨了保险不足人群的社会人口学和健康特征——这些人有一定的医疗保险，但在支付医疗保健或药物费用方面存在困难。它使用了来自波士顿地区社区健康（BACH）调查的数据，这是一项针对 30 至 79 岁波士顿居民的大型（N=5503）基于社区的随机抽样调查，其中包括 1767 名黑人、1877 名西班牙裔和 1859 名白人；2301 名男性和 3202 名女性。作者发现，少数民族拥有医疗保险的可能性低于白人（分别为男性和女性，30%和 19%的西班牙裔、16%和 9%的黑人以及 9%和 7%的白人没有医疗保险）。黑人最有可能保险不足（分别为男性和女性，18%和 20%的黑人与 9%和 14%的西班牙裔以及 8%和 12%的白人保险不足）。社会经济地位较低和中等的人也更有可能没有保险或保险不足。未参保者的健康状况与参保充足者相似，而保险不足者报告的合并症和抑郁更多。保险不足者通常年龄更大、病情更重，并且更多地利用医疗保健系统，他们可能比未参保者对公共卫生和卫生政策构成更大的挑战。
