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保险覆盖类型对美国自闭症儿童获得和利用医疗服务的影响。

The Impact of Insurance Coverage Types on Access to and Utilization of Health Services for U.S. Children With Autism.

作者信息

Zhang Wanqing, Baranek Grace

机构信息

The authors are with the Department of Allied Health Sciences, University of North Carolina, Chapel Hill (e-mail:

出版信息

Psychiatr Serv. 2016 Aug 1;67(8):908-11. doi: 10.1176/appi.ps.201500206. Epub 2016 Apr 15.

Abstract

OBJECTIVE

The study examined the association of insurance type with access to and utilization of essential health services among children with autism spectrum disorder (ASD).

METHODS

Multivariate logistic regressions were used to illustrate the relationship between the indicators of health services utilization and insurance coverage types among U.S. children with ASD (N=2,041). Analyses used secondary data from the 2011-2012 National Survey of Children's Health.

RESULTS

Privately insured children with ASD were significantly less likely than their publicly insured counterparts to receive therapy (OR=.49). The odds of having any out-of-pocket medical expenses for families with private insurance were 11.0 times greater than for families with public insurance.

CONCLUSIONS

The findings reflect current gaps between public and private insurance coverage in the health system for access to and utilization of health services for children with ASD. Special attention should be directed to private insurance plans, where needed health services may be inadequately covered.

摘要

目的

本研究探讨了保险类型与自闭症谱系障碍(ASD)儿童获得和利用基本医疗服务之间的关联。

方法

采用多变量逻辑回归分析美国患有自闭症谱系障碍的儿童(N = 2041)的医疗服务利用指标与保险覆盖类型之间的关系。分析使用了2011 - 2012年全国儿童健康调查的二手数据。

结果

与参加公共保险的自闭症谱系障碍儿童相比,参加私人保险的儿童接受治疗的可能性显著更低(比值比 = 0.49)。有私人保险的家庭产生自付医疗费用的几率比有公共保险的家庭高11.0倍。

结论

研究结果反映了当前卫生系统中公共保险和私人保险在自闭症谱系障碍儿童获得和利用医疗服务方面存在的差距。应特别关注私人保险计划,因为所需的医疗服务可能在这些计划中覆盖不足。

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