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2011 - 2015年美国医疗保健可及性方面的社会经济、地理空间和地缘政治差异

Socioeconomic, Geospatial, and Geopolitical Disparities in Access to Health Care in the US 2011-2015.

作者信息

Towne Samuel D

机构信息

Department of Health Promotion and Community Health Sciences, School of Public Health, Texas A&M University, College Station, TX 77846, USA.

出版信息

Int J Environ Res Public Health. 2017 May 29;14(6):573. doi: 10.3390/ijerph14060573.

Abstract

Individuals forgoing needed medical care due to barriers associated with cost are at risk of missing needed care that may be necessary for the prevention or maintenance of a chronic condition among other things. Thus, continued monitoring of factors associated with forgone medical care, especially among vulnerable populations, is critical. National survey data (2011-2015) for non-institutionalized adults residing in the USA were utilized to assess forgone medical care, defined as not seeking medical care when the individual thought it was necessary because of cost in the past 12 months. Logistic regression was used to predict forgone medical care vs. sought medical care. Racial/ethnic minority working-age adults, those with lower incomes, those with lower educations, those residing in the South, and those residing in states that failed to participate in Medicaid Expansion in 2014 were more likely (p < 0.01) to forgo medical care due to cost in the past year. Policy makers seeking to reduce barriers to forgone medical care can use this information to tailor their efforts (e.g., mechanisms targeted to bridge gaps in access to care) to those most at-risk and to consider state-level policy decisions that may impact access to care.

摘要

由于与成本相关的障碍而放弃必要医疗护理的个人,面临错过预防或维持慢性病等所需护理的风险。因此,持续监测与放弃医疗护理相关的因素,尤其是在弱势群体中,至关重要。利用美国非机构化成年人的全国调查数据(2011 - 2015年)来评估放弃的医疗护理,其定义为在过去12个月中,个人因成本原因认为有必要就医时却未寻求医疗护理。使用逻辑回归来预测放弃医疗护理与寻求医疗护理的情况。在过去一年中,种族/族裔少数工作年龄成年人、低收入者、受教育程度较低者、居住在南方的人以及居住在2014年未参与医疗补助扩大计划州的人,因成本原因更有可能(p < 0.01)放弃医疗护理。寻求减少放弃医疗护理障碍的政策制定者可以利用这些信息,针对风险最高的人群调整其努力(例如,旨在弥合医疗护理获取差距的机制),并考虑可能影响医疗护理获取的州级政策决策。

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