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医疗保险覆盖范围与就医便利性方面的不良体验:美国,2012年

Health insurance coverage and adverse experiences with physician availability: United States, 2012.

作者信息

Gindi Renee M, Kirzinger Whitney K, Cohen Robin A

出版信息

NCHS Data Brief. 2013 Dec(138):1-8.

PMID:24352196
Abstract

Data from the National Health Interview Survey, 2012. In the 12 months prior to interview, 2.4% of people in the U.S. had problems finding a general doctor, 2.1% had been told that a doctor would not accept them as new patients, and 2.9% had been told that a doctor did not accept their health care coverage. People under age 65 who had public coverage only were more likely than those with private insurance to have these three types of adverse experiences with physician availability. Adults aged 18-64 who were uninsured were more likely than privately insured adults to have trouble finding a general doctor or be told that a doctor would not accept them as new patients. Adults aged 65 and over with Medicare only were as likely as those with both Medicare and private insurance to have these experiences with physician availability. Rates of private insurance and public coverage have been increasing (1,2). As coverage and utilization increase, a growing concern is the availability of health care providers to meet patient needs (3). Almost 90% of general physicians accept new patients with private insurance, but less than 75% accept new patients with public coverage (e.g., Medicare, Medicaid), and the proportion of specialists accepting new patients with Medicare or Medicaid is declining (4). While most studies approach access from a provider perspective, this report examines the percentage of people who had each of three adverse experiences with physician availability in the past 12 months. Estimates were produced by age group and health insurance status using data from the 2012 National Health Interview Survey (NHIS).

摘要

数据来自2012年美国国家健康访谈调查。在接受访谈前的12个月里,美国2.4%的人在找普通医生时遇到问题,2.1%的人被告知医生不接受他们作为新患者,2.9%的人被告知医生不接受他们的医保。仅拥有公共医保的65岁以下人群比拥有私人保险的人群更有可能在医生可及性方面有这三种不良经历。18 - 64岁未参保的成年人比参保的成年人更有可能在找普通医生时遇到困难或被告知医生不接受他们作为新患者。仅拥有医疗保险的65岁及以上成年人与同时拥有医疗保险和私人保险的成年人在医生可及性方面有这些经历的可能性相同。私人保险和公共医保的覆盖率一直在上升(1,2)。随着覆盖率和利用率的提高,一个日益令人担忧的问题是医疗服务提供者能否满足患者需求(3)。近90%的普通医生接受有私人保险的新患者,但接受有公共医保(如医疗保险、医疗补助)新患者的比例不到75%,接受医疗保险或医疗补助新患者的专科医生比例正在下降(4)。虽然大多数研究从医疗服务提供者的角度探讨可及性,但本报告考察了在过去12个月里在医生可及性方面有三种不良经历的人群比例。使用2012年美国国家健康访谈调查(NHIS)的数据按年龄组和健康保险状况进行了估计。

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