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医疗补助计划的参保取消与医疗服务可及性方面的差异:来自田纳西州的证据。

Medicaid Disenrollment and Disparities in Access to Care: Evidence from Tennessee.

作者信息

Tarazi Wafa W, Green Tiffany L, Sabik Lindsay M

机构信息

Department of Health Behavior and Policy, School of Medicine, Virginia Commonwealth University, Richmond, VA.

出版信息

Health Serv Res. 2017 Jun;52(3):1156-1167. doi: 10.1111/1475-6773.12515. Epub 2016 Jun 3.

Abstract

OBJECTIVE

To assess the effects of Tennessee's 2005 Medicaid disenrollment on access to health care among low-income nonelderly adults.

DATA SOURCE/STUDY SETTING: We use data from the 2003-2008 Behavioral Risk Factor Surveillance System.

STUDY DESIGN

We examined the effects of Medicaid disenrollment on access to care among adults living in Tennessee compared with neighboring states, using difference-in-difference models.

PRINCIPAL FINDINGS

Evidence suggests that Medicaid disenrollment resulted in significant decreases in health insurance and increases in cost-related barriers to care for low-income adults living in Tennessee. Statistically significant changes were not observed for having a personal doctor.

CONCLUSIONS

Medicaid disenrollment is associated with reduced access to care. This finding is relevant for states considering expansions or contractions of Medicaid under the Affordable Care Act.

摘要

目的

评估田纳西州2005年医疗补助计划参保资格取消对低收入非老年成年人获得医疗保健服务的影响。

数据来源/研究背景:我们使用了2003 - 2008年行为风险因素监测系统的数据。

研究设计

我们采用双重差分模型,将田纳西州的成年人与邻近州的成年人进行比较,研究医疗补助计划参保资格取消对获得医疗服务的影响。

主要发现

有证据表明,医疗补助计划参保资格取消导致田纳西州低收入成年人的医疗保险显著减少,与医疗费用相关的就医障碍增加。在拥有私人医生方面未观察到具有统计学意义的变化。

结论

医疗补助计划参保资格取消与获得医疗服务的机会减少有关。这一发现对于考虑根据《平价医疗法案》扩大或缩减医疗补助计划的州具有参考价值。

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