Lurie Institute for Disability Policy, Heller School for Social Policy and Management, Brandeis University, 415 South Street, MS 035, Waltham, MA 02454, USA.
Intellect Dev Disabil. 2012 Jun;50(3):190-8. doi: 10.1352/1934-9556-50.3.190.
We examined the association between states' legislative mandates that private insurance cover autism services and the health care-related financial burden reported by families of children with autism. Child and family data were drawn from the National Survey of Children with Special Health Care Needs (N = 2,082 children with autism). State policy characteristics were taken from public sources. The 3 outcomes were whether a family had any out-of-pocket health care expenditures during the past year for their child with autism, the expenditure amount, and expenditures as a proportion of family income. We modeled the association between states' autism service mandates and families' financial burden, adjusting for child-, family-, and state-level characteristics. Overall, 78% of families with a child with autism reported having any health care expenditures for their child for the prior 12 months. Among these families, 54% reported expenditures of more than $500, with 34% spending more than 3% of their income. Families living in states that enacted legislation mandating coverage of autism services were 28% less likely to report spending more than $500 for their children's health care costs, net of child and family characteristics. Families living in states that enacted parity legislation mandating coverage of autism services were 29% less likely to report spending more than $500 for their children's health care costs, net of child and family characteristics. This study offers preliminary evidence in support of advocates' arguments that requiring private insurers to cover autism services will reduce families' financial burdens associated with their children's health care expenses.
我们考察了各州立法要求私人保险涵盖自闭症服务与自闭症儿童家庭报告的与医疗保健相关的经济负担之间的关联。儿童和家庭数据来自国家特殊需要儿童健康调查(N=2082 名自闭症儿童)。州政策特征取自公共来源。3 个结果是家庭在过去一年中是否有为其自闭症儿童支付任何自付医疗保健费用,支出金额以及支出占家庭收入的比例。我们对州自闭症服务授权与家庭经济负担之间的关联进行了建模,调整了儿童、家庭和州级特征。总体而言,78%的自闭症儿童家庭报告在过去 12 个月中为其孩子的医疗保健支出了任何费用。在这些家庭中,54%报告支出超过 500 美元,其中 34%支出超过其收入的 3%。与没有颁布立法要求涵盖自闭症服务的州相比,颁布立法要求涵盖自闭症服务的州的家庭报告其孩子的医疗保健费用超过 500 美元的可能性低 28%,这是在考虑了儿童和家庭特征后得出的。与没有颁布涵盖自闭症服务的平等待遇立法的州相比,颁布涵盖自闭症服务的平等待遇立法的州的家庭报告其孩子的医疗保健费用超过 500 美元的可能性低 29%,这是在考虑了儿童和家庭特征后得出的。本研究初步提供了证据支持倡导者的论点,即要求私人保险公司涵盖自闭症服务将减轻家庭与儿童医疗保健费用相关的经济负担。