全州基本健康福利对减重手术利用的影响。
Impact of Statewide Essential Health Benefits on Utilization of Bariatric Surgery.
机构信息
National Clinician Scholars Program at the Institute for Healthcare Policy and Innovation, University of Michigan, 2800 Plymouth Road, Building 14, Room G100, Ann Arbor, MI, 48109, USA.
Center for Healthcare Outcomes and Policy, University of Michigan, 2800 Plymouth Road, Building 16, 016-100N-28, Ann Arbor, MI, 48109, USA.
出版信息
Obes Surg. 2020 Jan;30(1):374-377. doi: 10.1007/s11695-019-04092-z.
BACKGROUND
In response to concerns about inadequate insurance coverage, bariatric surgery was included in the Affordable Care Act's essential health benefits program-requiring individual and small-group insurance plans in 23 states to cover bariatric surgery. We evaluated the impact of this policy on bariatric surgery utilization.
METHODS
Multiple-group interrupted time series analyses of IBM MarketScan commercial claims data from 2009 to 2016.
RESULTS
Bariatric surgery utilization increased in all states after ACA implementation, but this increase was no greater in states with a bariatric surgery essential health benefit.
CONCLUSIONS
Our findings suggest that the essential health benefits program may have been too narrow in scope to meaningfully increase bariatric surgery utilization at the population level.
背景
为了应对保险覆盖不足的担忧，减重手术被纳入《平价医疗法案》的基本健康福利计划中，要求 23 个州的个人和小团体保险计划覆盖减重手术。我们评估了这项政策对减重手术利用率的影响。
方法
使用 2009 年至 2016 年 IBM MarketScan 商业索赔数据的多群组中断时间序列分析。
结果
ACA 实施后，所有州的减重手术利用率都有所增加，但在有减重手术基本健康福利的州，这种增加并不明显。
结论
我们的研究结果表明，基本健康福利计划的范围可能过于狭窄，无法在人群层面上显著增加减重手术的利用率。
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