MDRC, Oakland, CA 94612, USA.
Med Care. 2012 Sep;50(9):764-71. doi: 10.1097/MLR.0b013e31825a8bfc.
Under current law, most Social Security Disability Insurance (SSDI) beneficiaries are not eligible for Medicare until 29 months after the Social Security Administration determines the onset of their disability. During this waiting period, >1 in 5 lacks health insurance. This study investigated the effects of providing health care benefits on the health, employment, and other services of uninsured beneficiaries.
New SSDI beneficiaries without health insurance were randomly assigned to receive health care benefits, health care benefits plus additional supports, or a control group.
Compared with a control group, those provided health care benefits used more health care, had fewer unmet medical needs, spent less out of pocket on health care, and reported improved health. In addition, those provided the additional supports were more likely to look for work, but the supports did not affect work or SSDI benefits at this very early period.
The results provide rigorous evidence that health care benefits can increase health care use and health outcomes. Longer-term follow-up is needed to fully assess the program's effects on its ultimate benefits and costs, including its long-term effects on health, employment, and benefit receipt.
根据现行法律，大多数社会保障残疾保险（SSDI）受益人在社会保障管理局确定其残疾开始后的 29 个月内没有资格获得医疗保险。在此等待期间，超过五分之一的人没有医疗保险。本研究调查了提供医疗保健福利对未参保受益人的健康、就业和其他服务的影响。
没有医疗保险的新 SSDI 受益人被随机分配接受医疗保健福利、医疗保健福利加额外支持或对照组。
与对照组相比，那些获得医疗保健福利的人使用了更多的医疗保健服务，医疗需求未得到满足的情况更少，在医疗保健上的自付费用更少，报告的健康状况有所改善。此外，那些获得额外支持的人更有可能寻找工作，但在这个非常早期的阶段，支持并没有影响工作或 SSDI 福利。
结果提供了严格的证据，表明医疗保健福利可以增加医疗保健的使用和健康结果。需要进行更长期的随访，以充分评估该计划对其最终效益和成本的影响，包括其对健康、就业和福利领取的长期影响。
