Florida International University, Miami, FL, USA.
Med Care Res Rev. 2020 Oct;77(5):483-497. doi: 10.1177/1077558718810129. Epub 2018 Nov 7.
High-deductible health plans (HDHPs) have become increasingly prevalent among employer-sponsored health plans and plans offered through the Health Insurance Marketplace in the United States. This study examined the impact of deductible levels on health care experiences in terms of care access, affordability, routine checkup, out-of-pocket cost, and satisfaction using data from the Health Reform Monitoring Survey. The study also tested whether the experiences of Marketplace enrollees differed from off-Marketplace individuals, controlling for deductible levels. Results from multivariable and propensity score weighted regression models showed that many of the outcomes were adversely affected by deductible levels and Marketplace enrollment. These results highlight the importance of efforts to help individuals choose the plan that fits both their medical needs and their budgets. The study also calls for more attention to improving provider acceptance of HDHPs and Marketplace plans as these plans become increasingly common over time.
高自付额健康计划（HDHPs）在美国越来越普遍，出现在雇主赞助的健康计划和通过医疗保险市场提供的计划中。本研究使用来自健康改革监测调查的数据，考察了自付额水平对医疗保健体验（包括获得医疗服务的机会、负担能力、常规检查、自付费用和满意度）的影响。该研究还测试了市场参与者的体验是否与非市场参与者不同，同时控制了自付额水平。多变量和倾向评分加权回归模型的结果表明，许多结果都受到自付额水平和市场参与者身份的不利影响。这些结果强调了帮助个人选择既符合其医疗需求又符合其预算的计划的重要性。该研究还呼吁更多地关注提高医疗服务提供者对 HDHPs 和市场计划的接受度，因为随着时间的推移，这些计划越来越普遍。
