Farietta Thalia P, Lu Bo, Tumin Rachel
Center for Outcomes Research and Evaluation, Yale University, 1 Church Street #200, New Haven, CT, 06510, USA.
The Ohio State University College of Public Health, 244 Cunz Hall, 1841 Neil Ave, Columbus, OH, 43210, USA.
Matern Child Health J. 2018 Dec;22(12):1771-1779. doi: 10.1007/s10995-018-2575-1.
Objective To examine changes in the prevalence and odds of unmet healthcare needs and healthcare utilization among low-income women of reproductive age (WRA) after Ohio's 2014, ACA-associated Medicaid expansion, which extended coverage to non-senior adults with a family income ≤ 138% of the federal poverty level. Methods We analyzed publically available data from the 2012 and 2015 Ohio Medicaid Assessment Survey (OMAS), a cross-sectional telephone survey of Ohio's non-institutionalized adult population. The study included 489 low-income women in 2012 and 1273 in 2015 aged 19-44 years who were newly eligible for Medicaid after expansion in January 2014. Four unmet healthcare need and three healthcare utilization measures were examined. We fit survey-weighted logistic regression models adjusted for race/ethnicity, working status, and educational attainment to determine whether the odds of each measure differed between 2012 and 2015. Results In 2015, low-income WRA had a significantly lower odds of reporting an unmet dental care need (OR = 0.72, 95% CI 0.54, 0.95), unmet vision care need (OR = 0.68, 95% CI 0.50, 0.93), unmet mental health need (OR = 0.57, 95% CI 0.39, 0.83), and unmet prescription need (OR = 0.39, 95% CI 0.45, 0.80) compared to 2012. There were no significant differences in the odds of seeing a doctor or dentist in the past year or of having a usual source of care for low-income WRA in 2012 and 2015. Conclusions for Practice After Ohio's 2014 Medicaid expansion the odds of low-income WRA having unmet healthcare needs was reduced. Future research should examine outcomes after a longer period of follow-up and include additional measures, such as self-rated health status.
目的 考察俄亥俄州2014年与《平价医疗法案》相关的医疗补助扩大计划实施后，低收入育龄妇女未满足的医疗需求及医疗服务利用情况的患病率和几率的变化。该计划将保险覆盖范围扩大到家庭收入≤联邦贫困线138%的非老年人。方法 我们分析了2012年和2015年俄亥俄医疗补助评估调查（OMAS）的公开数据，这是一项对俄亥俄州非机构化成年人口的横断面电话调查。该研究纳入了2012年的489名低收入妇女和2015年的1273名19 - 44岁的低收入妇女，她们在2014年1月扩大计划后新符合医疗补助资格。考察了四项未满足的医疗需求和三项医疗服务利用指标。我们拟合了经种族/民族、工作状态和教育程度调整的调查加权逻辑回归模型，以确定2012年和2015年各项指标的几率是否存在差异。结果 2015年，与2012年相比，低收入育龄妇女报告未满足的牙科护理需求（比值比[OR]=0.72，95%置信区间[CI]0.54, 0.95）、未满足的视力护理需求（OR = 0.68，95% CI 0.50, 0.93）、未满足的心理健康需求（OR = 0.57，95% CI 0.39, 0.83）以及未满足的处方需求（OR = 0.39，95% CI 0.45, 0.80）的几率显著降低。2012年和2015年，低收入育龄妇女在过去一年看医生或牙医的几率以及有常规医疗服务来源的几率没有显著差异。实践结论 俄亥俄州2014年医疗补助扩大计划实施后，低收入育龄妇女未满足医疗需求的几率降低。未来的研究应在更长的随访期后考察结果，并纳入其他指标，如自评健康状况。
