Gao Shiyao, Kumar Raj G, Wisniewski Stephen R, Fabio Anthony
Epidemiology Data Center (Ms Gao and Drs Wisniewski and Fabio) and Departments of Epidemiology and Physical Medicine and Rehabilitation (Mr Kumar), University of Pittsburgh, Pittsburgh, Pennsylvania.
J Head Trauma Rehabil. 2018 May/Jun;33(3):E40-E50. doi: 10.1097/HTR.0000000000000338.
To characterize racial/ethnic and insurance disparities in the utilization of healthcare services among US adults with traumatic brain injury (TBI).
The PubMed database was used to search for articles that directly examined the association between race/ethnicity and insurance disparities and healthcare utilization among patients with TBI. Eleven articles that met the criteria and were published between June 2011 and June 2016 were finally included in the review.
Lack of insurance was significantly associated with decreased use of inhospital and posthospital healthcare services among patients with TBI. However, mixed results were reported for the associations between insurance types and healthcare utilization. The majority of studies reported that racial/ethnic minorities were less likely to use inhospital and posthospital healthcare services, while some studies did not indicate any significant relation between race/ethnicity and healthcare utilization among patients with TBI.
This review provides evidence of a relation between insurance status and healthcare utilization among US adults with TBI. Insurance status may also account for some portion of the relation between race/ethnicity and healthcare utilization.
描述美国创伤性脑损伤（TBI）成年患者在医疗服务利用方面的种族/民族及保险差异。
利用PubMed数据库检索直接研究种族/民族与保险差异以及TBI患者医疗服务利用之间关联的文章。最终纳入了11篇符合标准且于2011年6月至2016年6月期间发表的文章进行综述。
缺乏保险与TBI患者住院及出院后医疗服务利用的减少显著相关。然而，关于保险类型与医疗服务利用之间的关联，报告结果不一。大多数研究表明，种族/民族少数群体使用住院及出院后医疗服务的可能性较小，而一些研究并未表明TBI患者的种族/民族与医疗服务利用之间存在任何显著关系。
本综述提供了证据，证明美国成年TBI患者的保险状况与医疗服务利用之间存在关联。保险状况也可能在种族/民族与医疗服务利用之间的关系中占一定比例。
