《平价医疗法案》实施后，严重心理困扰人群的健康保险覆盖范围变化和获得医疗服务的障碍。
Changes in Health Insurance Coverage and Barriers to Health Care Access Among Individuals with Serious Psychological Distress Following the Affordable Care Act.
机构信息
Department of Health Services Administration, School of Public Health, University of Maryland at College Park, 4200 Valley Dr, Suite 2242, College Park, MD, 20742, USA.
出版信息
Adm Policy Ment Health. 2018 Nov;45(6):924-932. doi: 10.1007/s10488-018-0875-9.
Abstract
The Affordable Care Act (ACA) aims to expand health insurance coverage and minimize financial barriers to receiving health care services for individuals. However, little is known about how the ACA has impacted individuals with mental health conditions. This study finds that the implementation of the ACA is associated with an increase in rate of health insurance coverage among nonelderly adults with serious psychological distress (SPD) and a reduction in delaying and forgoing necessary care. The ACA also reduced the odds of an individual with SPD not being able to afford mental health care. Mental health care access among racial and ethnic minority populations and people with low income has improved during 2014-2016, but gaps remain.
摘要
平价医疗法案（ACA）旨在扩大医疗保险覆盖范围，并最大限度地减少个人获得医疗服务的经济障碍。然而，对于 ACA 如何影响心理健康状况的个人知之甚少。本研究发现，ACA 的实施与严重心理困扰（SPD）的非老年成年人的医疗保险覆盖率的增加以及延迟和放弃必要的护理的减少有关。ACA 还降低了 SPD 患者无法负担精神保健的可能性。在 2014 年至 2016 年期间，少数民族和低收入人群的精神保健服务的获得情况有所改善，但差距仍然存在。
相似文献
1
Changes in Health Insurance Coverage and Barriers to Health Care Access Among Individuals with Serious Psychological Distress Following the Affordable Care Act.《平价医疗法案》实施后，严重心理困扰人群的健康保险覆盖范围变化和获得医疗服务的障碍。
Adm Policy Ment Health. 2018 Nov;45(6):924-932. doi: 10.1007/s10488-018-0875-9.
2
Coverage and Access for Americans with Cardiovascular Disease or Risk Factors After the ACA: a Quasi-experimental Study.《ACA 后心血管疾病或风险因素的美国人的覆盖范围和获取：一项准实验研究》。
J Gen Intern Med. 2019 Sep;34(9):1797-1805. doi: 10.1007/s11606-019-05108-1. Epub 2019 Jun 27.
3
Medicaid Expansion and Health Insurance Coverage and Treatment Utilization among Individuals with a Mental Health Condition.医疗补助扩张与心理健康状况个体的医疗保险覆盖范围和治疗利用。
J Ment Health Policy Econ. 2020 Sep 1;23(3):151-182.
4
Mental Health Treatment Among Individuals Involved in the Criminal Justice System After Implementation of the Affordable Care Act.《平价医疗法案》实施后，刑事司法系统涉案人员的精神健康治疗。
Psychiatr Serv. 2019 Sep 1;70(9):765-771. doi: 10.1176/appi.ps.201800559. Epub 2019 May 29.
5
Racial and Ethnic Disparities in Health Care Access and Utilization Under the Affordable Care Act.《平价医疗法案》下医疗保健可及性与利用方面的种族和族裔差异
Med Care. 2016 Feb;54(2):140-6. doi: 10.1097/MLR.0000000000000467.
6
7
The impact of the Affordable Care Act on behavioral health care for individuals from racial and ethnic communities.《平价医疗法案》对种族和族裔社区个人行为健康护理的影响。
J Soc Work Disabil Rehabil. 2014;13(1-2):139-61. doi: 10.1080/1536710X.2013.870518.
8
The Affordable Care Act's Dependent Care Coverage Expansion and Behavioral Health Care.《平价医疗法案》的受抚养人护理保险覆盖范围扩大与行为健康护理
J Ment Health Policy Econ. 2017 Sep 1;20(3):111-130.
9
Disparities in Health Care Utilization and Functional Limitations Among Adults With Serious Psychological Distress, 2006-2014.2006 - 2014年严重心理困扰成年人的医疗保健利用和功能限制差异
Psychiatr Serv. 2017 Jul 1;68(7):653-659. doi: 10.1176/appi.ps.201600260. Epub 2017 Apr 17.
10
Insurance Loss in the Era of the Affordable Care Act: Association With Access to Health Services.平价医疗法案时代的保险损失：与获得医疗服务的关联。
Med Care. 2019 Aug;57(8):567-573. doi: 10.1097/MLR.0000000000001150.
引用本文的文献
1
Protocol for socioecological study of autism, suicide risk, and mental health care: Integrating machine learning and community consultation for suicide prevention.自闭症、自杀风险和心理健康护理的社会生态研究方案：整合机器学习与社区咨询以预防自杀
PLoS One. 2025 Mar 19;20(3):e0319396. doi: 10.1371/journal.pone.0319396. eCollection 2025.
2
Racial Differences in the Prevalence of Autism Spectrum Disorder: A Systematic Review.自闭症谱系障碍患病率的种族差异：一项系统综述。
J Autism Dev Disord. 2024 Jun 28. doi: 10.1007/s10803-024-06403-5.
3
Black Americans' perceptions of Alzheimer's disease, a healthy brain, and strategies for brain health promotion.美国黑人对阿尔茨海默病、健康大脑以及大脑健康促进策略的认知。
PEC Innov. 2024 Apr 19;4:100282. doi: 10.1016/j.pecinn.2024.100282. eCollection 2024 Dec.
4
Association of opioid or other substance use disorders with health care use among patients with suicidal symptoms.阿片类药物或其他物质使用障碍与有自杀症状患者的医疗保健使用之间的关联。
J Subst Use Addict Treat. 2024 Jan;156:209177. doi: 10.1016/j.josat.2023.209177. Epub 2023 Oct 9.
5
From East to West: A Narrative Review of Healthcare Models in India and the United States.从东到西：印度和美国医疗保健模式的叙述性综述
Cureus. 2023 Aug 14;15(8):e43456. doi: 10.7759/cureus.43456. eCollection 2023 Aug.
6
Impacts of the Affordable Care Act Medicaid Expansion on Mental Health Treatment Among Low-income Adults Across Racial/Ethnic Subgroups, 2010-2017.平价医疗法案医疗补助扩大计划对 2010-2017 年间不同种族/民族亚组中低收入成年人心理健康治疗的影响。
J Behav Health Serv Res. 2024 Jan;51(1):57-73. doi: 10.1007/s11414-023-09861-4. Epub 2023 Sep 6.
7
A call to create evidence-based mental health promotion interventions for youth that are equitable across ethnic/racial subgroups: Advocates 4-ALL Youth.呼吁为青年创建基于证据的心理健康促进干预措施，使不同族裔/种族亚组之间公平：倡导 4-ALL 青年。
Front Public Health. 2023 Apr 21;11:1139921. doi: 10.3389/fpubh.2023.1139921. eCollection 2023.
8
Effects of the Affordable Care Act Medicaid Expansions on Mental Health During the COVID-19 Pandemic in 2020-2021.2020-2021 年 COVID-19 大流行期间平价医疗法案医疗补助扩张对心理健康的影响。
Inquiry. 2023 Jan-Dec;60:469580231166738. doi: 10.1177/00469580231166738.
9
Changes in General Health and Mental Health Outcomes in an Urban Population Over a Decade: A Population-Representative Analysis Stratified by Sexual Orientation.在过去十年中，城市人口的一般健康和心理健康结果的变化：按性取向分层的代表性人群分析。
LGBT Health. 2022 Oct;9(7):512-519. doi: 10.1089/lgbt.2021.0217. Epub 2022 Jul 25.
10
Estimating a Model for Mental Healthcare Utilization Using Subjective Unmet Need and Psychological Distress Measures.使用主观未满足需求和心理困扰指标估计心理保健利用模型。
J Behav Health Serv Res. 2022 Oct;49(4):500-512. doi: 10.1007/s11414-022-09797-1. Epub 2022 May 9.
本文引用的文献
1
Differential Reimbursement of Psychiatric Services by Psychiatrists and Other Medical Providers.精神科医生和其他医疗服务提供者对精神科服务的差别性报销。
Psychiatr Serv. 2018 Mar 1;69(3):281-285. doi: 10.1176/appi.ps.201700271. Epub 2017 Dec 1.
2
Insurance Coverage and Treatment Use Under the Affordable Care Act Among Adults With Mental and Substance Use Disorders.《平价医疗法案》下患有精神疾病和物质使用障碍的成年人的保险覆盖范围及治疗利用情况
Psychiatr Serv. 2017 Jun 1;68(6):542-548. doi: 10.1176/appi.ps.201600182. Epub 2017 Jan 17.
3
Psychological Distress and Enrollment in Medicaid.心理困扰与医疗补助登记
J Behav Health Serv Res. 2017 Oct;44(4):523-535. doi: 10.1007/s11414-016-9532-9.
4
Racial and Ethnic Disparities Among the Remaining Uninsured Young Adults with Behavioral Health Disorders After the ACA Expansion of Dependent Coverage.《ACA 扩大依赖型保险覆盖范围后，行为健康障碍的剩余未参保年轻成年人中的种族和民族差异》
J Racial Ethn Health Disparities. 2017 Aug;4(4):607-614. doi: 10.1007/s40615-016-0264-6. Epub 2016 Jul 22.
5
Access To Mental Health Care Increased But Not For Substance Use, While Disparities Remain.获得心理健康护理的机会有所增加，但物质使用方面的机会并未增加，同时差距依然存在。
Health Aff (Millwood). 2016 Jun 1;35(6):1017-21. doi: 10.1377/hlthaff.2016.0098.
6
The ACA's Dependent Coverage Expansion and Out-of-Pocket Spending by Young Adults With Behavioral Health Conditions.《平价医疗法案》对患有行为健康问题的年轻人的受抚养人保险范围扩大及自付费用情况
Psychiatr Serv. 2016 Sep 1;67(9):977-82. doi: 10.1176/appi.ps.201500346. Epub 2016 May 16.
7
Assessing the Individual, Neighborhood, and Policy Predictors of Disparities in Mental Health Care.评估心理健康护理差异的个体、社区及政策预测因素。
Med Care Res Rev. 2017 Aug;74(4):404-430. doi: 10.1177/1077558716646898. Epub 2016 May 4.
8
Early Coverage, Access, Utilization, and Health Effects Associated With the Affordable Care Act Medicaid Expansions: A Quasi-experimental Study.《与〈平价医疗法案〉医疗补助扩大相关的早期覆盖范围、可及性、利用率及健康影响：一项准实验研究》
Ann Intern Med. 2016 Jun 21;164(12):795-803. doi: 10.7326/M15-2234. Epub 2016 Apr 19.
9
Assessing the need for a new nationally representative household panel survey in the United States.评估美国开展一项新的全国代表性家庭调查的必要性。
J Econ Soc Meas. 2015;40(1-4):1-26. doi: 10.3233/JEM-150411.
10
Racial and Ethnic Disparities in Health Care Access and Utilization Under the Affordable Care Act.《平价医疗法案》下医疗保健可及性与利用方面的种族和族裔差异
Med Care. 2016 Feb;54(2):140-6. doi: 10.1097/MLR.0000000000000467.
Zotero 插件