平价医疗法案的家属保险覆盖范围扩大是否影响了健康保险覆盖范围的种族/民族差异？
Did the Affordable Care Act's Dependent Coverage Expansion Affect Race/Ethnic Disparities in Health Insurance Coverage?
机构信息
RAND Corporation, Pittsburgh , PA.
RAND Corporation, Santa Monica, CA.
出版信息
Health Serv Res. 2018 Apr;53(2):1286-1298. doi: 10.1111/1475-6773.12728. Epub 2017 Jun 8.
Abstract
OBJECTIVE
To test the impact of the dependent coverage expansion (DCE) on insurance disparities across race/ethnic groups.
DATA SOURCES/STUDY SETTING: Survey data from the National Survey of Drug Use and Health (NSDUH).
STUDY DESIGN
Triple-difference (DDD) models were applied to repeated cross-sectional surveys of the U.S. adult population.
DATA COLLECTION/EXTRACTION METHODS: Data from 6 years (2008-2013) of the NSDUH were combined.
PRINCIPAL FINDINGS
Following the DCE, the relative odds of insurance increased 1.5 times (95 percent CI 1.1, 1.9) among whites compared to blacks and 1.4 times (95 percent CI 1.1, 1.8) among whites compared to Hispanics.
CONCLUSIONS
Health reform efforts, such as the DCE, can have negative effects on race/ethnic disparities, despite positive impacts in the general population.
摘要
目的
检验从属覆盖范围扩大（DCE）对不同种族/族裔群体保险差距的影响。
数据来源/研究环境：国家药物使用与健康调查（NSDUH）的调查数据。
研究设计
采用三重差分（DDD）模型对美国成年人群的重复横断面调查进行分析。
数据收集/提取方法：将 NSDUH 6 年（2008-2013 年）的数据合并。
主要发现
在 DCE 之后，与黑人相比，白人的保险相对几率增加了 1.5 倍（95%置信区间 1.1，1.9），与西班牙裔相比，白人的保险相对几率增加了 1.4 倍（95%置信区间 1.1，1.8）。
结论
尽管对一般人群有积极影响，但像 DCE 这样的医疗改革努力可能会对种族/族裔差异产生负面影响。
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