Department of Healthcare Policy and Research, Virginia Commonwealth University School of Medicine, Richmond, VA 23298, USA.
Med Care Res Rev. 2012 Apr;69(2):215-30. doi: 10.1177/1077558711418519. Epub 2011 Aug 17.
The uninsured fare worse than the insured on various measures, yet there is little evidence regarding trends in care for the uninsured and disparities by insurance status. Given changes in the health care system and the safety net, disparities between insured and uninsured populations may be changing over time. This article considers trends in access, chronic disease control, and heart attack care by insurance status and the disparity in these measures between uninsured and insured nonelderly adults, controlling for demographic characteristics to account for potential changes in the composition of these populations. Rates for the uninsured for all outcomes have generally been stable from the mid-1990s to mid-2000s, with fluctuation in some measures over shorter periods. In addition, there is a persistent disparity between the privately insured and uninsured on access measures. The gap between the uninsured and insured has not narrowed, though disparities generally have not worsened either.
在各种指标上，未参保者的状况比参保者差，但是有关无保险人群的医疗服务趋势和保险状况差异的证据很少。鉴于医疗保健系统和安全网的变化，参保者和未参保者之间的差距可能会随着时间的推移而发生变化。本文考虑了按保险状况划分的获得医疗服务、慢性病控制和心脏病治疗方面的趋势，以及在控制人口特征以说明这些人群构成的潜在变化后，在这些措施上未参保者与参保非老年成年人之间的差异。所有结果的未参保者的比率从 20 世纪 90 年代中期到 21 世纪中期一直保持稳定，一些指标在较短时期内有波动。此外，在获得医疗服务的措施方面，私人保险者和未参保者之间一直存在差距。虽然差距并没有缩小，但总体而言，差异也没有恶化。
