Department of Psychiatry, Harvard Medical School and Cambridge Health Alliance, 120 Beacon St., 4th Floor, Somerville, MA 02143, USA.
Health Serv Res. 2012 Jun;47(3 Pt 2):1322-44. doi: 10.1111/j.1475-6773.2012.01403.x. Epub 2012 Mar 30.
To estimate whether racial/ethnic behavioral health service disparities are likely to be reduced through insurance expansion coverage expected through the Affordable Health Care Act.
Pooled data from the nationally representative NIMH Collaborative Psychiatric Epidemiological Studies (2001-2003).
We employ a novel reweighting method to estimate service disparities in the presence and absence of insurance coverage.
Access to care was assessed by whether any behavioral health treatment was received in the past year. Need was determined by presence of prior year psychiatric disorder, psychiatric diagnoses, physical comorbidities, gender, and age.
Improving patient education and availability of community clinics, combined with insurance coverage reduces service disparities across racial/ethnic groups.However, even with expanded insurance coverage, approximately 10 percent fewer African Americans with need for behavioral health services are likely to receive services compared to non-Latino whites while Latinos show no measurable disparity.
Expansion of insurance coverage might have different effects for racial/ethnic groups, requiring additional interventions to reduce disparities for all groups.
评估平价医疗法案预计将扩大保险范围,这是否可能减少种族/民族行为健康服务的差距。
国家代表性的 NIMH 合作精神流行病学研究(2001-2003 年)的汇总数据。
我们采用一种新颖的重新加权方法,在存在和不存在保险覆盖的情况下估计服务差距。
通过过去一年是否接受任何行为健康治疗来评估获得治疗的情况。需求通过前一年的精神障碍、精神诊断、身体合并症、性别和年龄来确定。
提高患者教育和社区诊所的可及性,结合保险覆盖范围,减少了不同种族/民族群体之间的服务差距。然而,即使扩大了保险覆盖范围,与非拉丁裔白人相比,需要行为健康服务的非裔美国人获得服务的可能性仍将减少约 10%,而拉丁裔人则没有可衡量的差距。
保险范围的扩大可能对不同种族/民族群体产生不同的影响,需要采取额外的干预措施来减少所有群体的差距。