美国 1997-2010 年精神卫生服务未满足需求的差异。
Disparities in unmet need for mental health services in the United States, 1997-2010.
机构信息
Division of Health Sciences, Department of Health Policy and Administration, and College of Nursing, Washington State University, P.O.B. 1495, Spokane, WA 99210, USA.
出版信息
Psychiatr Serv. 2013 Jan;64(1):80-2. doi: 10.1176/appi.ps.201200071.
OBJECTIVES
This study estimated unmet need for mental health services, identified population risk factors related to unmet need, and established baseline data to assess the impact of the Affordable Care Act (ACA) and the Mental Health Parity and Addiction Equity Act.
METHODS
National Health Interview Survey data (1997-2010) were analyzed.
RESULTS
Unmet need increased from 4.3 million in 1997 to 7.2 million in 2010. Rates in 2010 were about five times higher for uninsured than for privately insured persons. In a multivariate logistic model, likelihood was higher among children (age two to 17), working-age adults (age 18-64), women, uninsured persons, persons with low incomes, in fair or poor health, and with chronic conditions.
CONCLUSIONS
Unmet need is widespread, particularly among the uninsured. Expansion of coverage under the ACA, in conjunction with federal parity, should improve access, but ongoing monitoring of access is a research and policy priority.
目的
本研究旨在评估心理健康服务的未满足需求，确定与未满足需求相关的人口风险因素，并建立基线数据，以评估《平价医疗法案》（ACA）和《精神健康和平等法案》的影响。
方法
对国家健康访谈调查数据（1997-2010 年）进行分析。
结果
未满足需求从 1997 年的 430 万增加到 2010 年的 720 万。2010 年，未参保人群的未满足需求率是参保人群的约五倍。在多变量逻辑模型中，儿童（2 至 17 岁）、劳动年龄成年人（18-64 岁）、女性、未参保人群、收入低的人群、健康状况不佳的人群和患有慢性病的人群的可能性更高。
结论
未满足需求非常普遍，尤其是在未参保人群中。ACA 下的覆盖范围扩大，加上联邦平等待遇，应该会改善获得服务的机会，但持续监测服务的获得情况是研究和政策的优先事项。
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