Department of Health Services Administration, School of Public Health, University of Maryland, College Park, MD, USA.
Health Aff (Millwood). 2010 Sep;29(9):1643-50. doi: 10.1377/hlthaff.2009.0906.
Eager to reduce unnecessary use of hospital emergency departments by Medicaid enrollees, states are increasingly implementing cost sharing for nonemergency visits. This paper uses monthly data from the 2001-2006 Medical Expenditure Panel Surveys (MEPS) to examine how changes in nine states' copayment policies influence enrollees' use of emergency departments. The results suggest that requiring copayments for nonemergency visits did not decrease emergency department use by Medicaid enrollees. Future research should examine more closely the effects at the state level and investigate whether these copayments affected the use of other services, such as hospitalizations or visits to physicians by Medicaid enrollees.
为了减少医疗补助计划参保者对医院急诊部门的不必要使用,各州越来越多地对非紧急就诊实行费用分担。本文利用 2001-2006 年医疗支出面板调查(MEPS)的月度数据,考察了九个州的共付政策变化如何影响参保者对急诊部门的使用。结果表明,对非紧急就诊收取共付费用并没有减少医疗补助计划参保者对急诊部门的使用。未来的研究应更仔细地考察州一级的影响,并调查这些共付是否影响了参保者对其他服务的使用,如住院或看医生。