RTI International, Washington, DC 20005, USA.
Epilepsy Behav. 2011 Nov;22(3):483-9. doi: 10.1016/j.yebeh.2011.07.007. Epub 2011 Sep 3.
We analyzed data from the 2002-2007 Medical Expenditure Panel Survey (MEPS) to assess whether individuals with epilepsy who are uninsured and those who have Medicaid coverage experience differences in medical resource utilization or out-of-pocket costs compared with those having other types of insurance. With sociodemographic characteristics controlled for, uninsured individuals had significantly fewer outpatient visits, fewer visits with neurologists, and greater antiepileptic drug costs than did those with private insurance. Individuals with Medicaid coverage had similar medical resource utilization rates but lower out-of-pocket costs compared with privately insured individuals. These findings indicate substantial barriers to receipt of appropriate medical care for uninsured individuals with epilepsy, but not for those with Medicaid coverage. Future studies should evaluate whether ongoing changes to the US health care system are able to address the differences in care we found among uninsured individuals with epilepsy and should incorporate measures of disease severity and unmet need.
我们分析了 2002-2007 年医疗支出面板调查（MEPS）的数据，以评估与其他类型保险相比，没有保险的癫痫患者和拥有医疗补助保险的癫痫患者在医疗资源利用或自付费用方面是否存在差异。在控制了社会人口特征后，与拥有私人保险的患者相比，没有保险的患者门诊就诊次数更少，看神经科医生的次数更少，抗癫痫药物费用更高。与私人保险患者相比，拥有医疗补助保险的患者具有相似的医疗资源利用率，但自付费用更低。这些发现表明，没有保险的癫痫患者获得适当医疗护理存在重大障碍，但拥有医疗补助保险的患者则没有这种障碍。未来的研究应该评估美国医疗保健系统的持续变化是否能够解决我们在没有保险的癫痫患者中发现的护理差异，并应纳入疾病严重程度和未满足需求的衡量标准。
