未参保者并非更多地使用急诊科——而是更少地使用其他医疗服务。
The Uninsured Do Not Use The Emergency Department More-They Use Other Care Less.
机构信息
Ruohua Annetta Zhou is a PhD candidate in health policy at Harvard University, in Cambridge, Massachusetts.
Katherine Baicker (
出版信息
Health Aff (Millwood). 2017 Dec;36(12):2115-2122. doi: 10.1377/hlthaff.2017.0218.
There is a popular perception that insurance coverage will reduce overuse of the emergency department (ED). Both opponents and advocates of expanding insurance coverage under the Affordable Care Act (ACA) have made statements to the effect that EDs have been jammed with the uninsured and that paying for the uninsured population's emergency care has burdened the health care system as a result of the expense of that care. It has therefore been surprising to many to encounter evidence that insurance coverage increases ED use instead of decreasing it. Two facts may help explain this unexpected finding. First, there is a common misperception that the uninsured use the ED more than the insured. In fact, insured and uninsured adults use the ED at very similar rates and in very similar circumstances-and the uninsured use the ED substantially less than the Medicaid population. Second, while the uninsured do not use the ED more than the insured, they do use other types of care much less than the insured.
有一种普遍的看法认为，保险范围的扩大将减少对急诊部（ED）的过度使用。平价医疗法案（ACA）的保险范围的扩大的反对者和支持者都表示，由于需要支付这些医疗费用，无保险人群的急诊护理给医疗保健系统带来了负担，因此，ED 已经挤满了无保险人群。因此，许多人惊讶地发现，保险范围的扩大反而增加了 ED 的使用，而不是减少了它。有两个事实可能有助于解释这一意外发现。首先，有一种普遍的误解认为，无保险人群比有保险人群更频繁地使用 ED。事实上，有保险和无保险的成年人使用 ED 的频率非常相似，而且无保险人群使用 ED 的频率要远远低于医疗补助人群。其次，虽然无保险人群使用 ED 的频率并不高于有保险人群，但他们使用其他类型的医疗服务的频率却远低于有保险人群。
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