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Latinos 内部族裔间的医疗保险覆盖差距与医改的影响。

Intra-Ethnic Coverage Disparities among Latinos and the Effects of Health Reform.

机构信息

Harvard University Graduate School of Arts and Sciences, Cambridge, MA.

Harvard University T.H. Chan School of Public Health, Boston, MA.

出版信息

Health Serv Res. 2018 Jun;53(3):1373-1386. doi: 10.1111/1475-6773.12733. Epub 2017 Jun 28.

Abstract

OBJECTIVE

To examine the patterns of insurance coverage among nine Latino subgroups and assess heterogeneous effects of the Affordable Care Act (ACA) among these groups.

DATA SOURCES

American Community Survey (2010-2014).

STUDY DESIGN

We examined pre-ACA disparities in coverage using linear probability models. Then, we used interrupted time series and triple-difference models to evaluate coverage changes associated with the ACA and Medicaid expansion, respectively.

PRINCIPAL FINDINGS

Pre-ACA coverage disparities between Latino subgroups were nearly 30 percentage points-larger than the gap between whites and Latinos as a whole. Coverage changes associated with the ACA and Medicaid expansion differed significantly between subgroups, with the largest gains among South Americans, Central Americans, and Mexicans.

CONCLUSIONS

Latino subgroups show marked heterogeneity in baseline coverage rates and responses to the ACA.

摘要

目的

考察九个拉丁裔亚群的保险覆盖模式,并评估平价医疗法案(ACA)在这些群体中的异质效应。

数据来源

美国社区调查(2010-2014 年)。

研究设计

我们使用线性概率模型考察了 ACA 之前覆盖范围的差异。然后,我们分别使用中断时间序列和三重差分模型来评估与 ACA 和医疗补助计划扩展相关的覆盖范围变化。

主要发现

拉丁裔亚群之间的 ACA 之前的覆盖范围差异接近 30 个百分点,比白人和拉丁裔整体之间的差距还要大。与 ACA 和医疗补助计划扩展相关的覆盖范围变化在亚群之间有显著差异,南美洲人、中美洲人和墨西哥人获益最大。

结论

拉丁裔亚群在基线覆盖率和对 ACA 的反应方面表现出显著的异质性。

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