The Child Health Evaluation and Research (CHEAR) Unit, Ann Arbor VA HSR&D Center for Practice Management and Outcomes Research and Center for Bioethics and Social Sciences in Medicine, University of Michigan, Ann Arbor, MI, USA; Division of General Pediatrics, Ann Arbor VA HSR&D Center for Practice Management and Outcomes Research and Center for Bioethics and Social Sciences in Medicine, University of Michigan, Ann Arbor, MI, USA.
Obesity (Silver Spring). 2013 Dec;21(12):E709-14. doi: 10.1002/oby.20387. Epub 2013 Jun 11.
To explore public opinion regarding insurance coverage for obesity treatment among severely obese adolescents.
The National Poll on Children's Health was fielded to a nationally representative sample of US adults, January 2011. Respondents (n = 2150) indicated whether insurance should cover specific weight management services for obese adolescents and whether private insurance and Medicaid should cover bariatric surgery. Sampling weights were applied to generate nationally representative results. Linear and logistic regression analyses were performed to assess associations.
More respondents endorsed insurance coverage for traditional healthcare services (mental health 86%, dietitian 84%) than for services generally viewed as outside the healthcare arena (exercise programs 65%, group programs 60%). For bariatric surgery, 81% endorsed private insurance coverage; 55% endorsed Medicaid coverage. Medicaid enrollees, black, Hispanic, and low-income respondents had greater odds (P < 0.05) of endorsing bariatric surgery coverage by Medicaid, compared to the referent groups (non-Hispanic white, income ≥$60K, private insurance).
Although public support for insurance coverage of traditional weight management services appears high, support for Medicaid coverage for bariatric surgery is lower and varies by demographics. If public opinion is a harbinger of future coverage, low-income adolescents could experience disparities in access to treatments like bariatric surgery.
探讨公众对为重度肥胖青少年提供肥胖治疗保险的看法。
2011 年 1 月，对美国成年人进行了全国性儿童健康调查。受访者（n=2150）表示保险是否应涵盖肥胖青少年特定的体重管理服务，以及私人保险和医疗补助是否应涵盖减重手术。采用抽样权重生成具有全国代表性的结果。进行线性和逻辑回归分析以评估关联。
与一般被认为不属于医疗保健领域的服务（运动计划 65%，团体计划 60%）相比，更多的受访者支持为传统医疗保健服务（心理健康 86%，营养师 84%）提供保险。对于减重手术，81%的人赞成私人保险；55%的人赞成医疗补助。与参照组（非西班牙裔白人、收入≥$60K、私人保险）相比，医疗补助受助人、黑人、西班牙裔和低收入受访者更有可能支持医疗补助覆盖减重手术（P<0.05）。
尽管公众对传统体重管理服务保险覆盖的支持似乎很高，但对医疗补助覆盖减重手术的支持较低，且因人口统计学因素而异。如果公众意见是未来覆盖范围的先兆，那么低收入青少年可能会在获得像减重手术这样的治疗方法方面存在差异。
