Center for Racism, Social Justice and Health, University of California, Los Angeles, Los Angeles, CA, USA.
Mailman School of Public Health, Columbia University, 60 Haven Avenue Suite B2 #212, 10032, New York, NY, USA.
J Community Health. 2020 Feb;45(1):30-40. doi: 10.1007/s10900-019-00708-8. Epub 2019 Aug 6.
To assess how the Affordable Care Act (ACA) impacted changes in access and utilization of health care between groups by examining differences across groups of immigrants and by citizenship status. Data came from respondents of the 2011-2016 National Health Interview Survey aged 18 to 64 who were born outside of the U.S. or were native-born non-Latino whites (N = 119,198). Outcome measures included (all in the past 12 months): being currently uninsured, being insured via Medicaid, visiting the emergency department, visiting a doctor at least once, delaying care due to costs, not getting needed care because respondent was unable to afford it and being told by doctor office that they would not accept you as a new patient. The ACA was associated with greater healthcare access and utilization for some groups, but heterogeneously across all groups. For example, some immigrant groups had better access and utilization than others, and similar variation was revealed across citizenship groups. This study underscores the importance of disentangling how policies can affect immigrants from different regions of the world, which has implications for healthcare utilization and disparities.
为了评估《平价医疗法案》(ACA)如何通过检查移民群体之间以及公民身份群体之间的差异来影响医疗保健获取和利用的变化,本研究使用了 2011 年至 2016 年全国健康访谈调查中年龄在 18 至 64 岁之间的、出生在美国境外或土生土长的非拉丁裔白人(N=119198)受访者的数据。结果测量指标包括(均在过去 12 个月内):当前是否没有保险、是否通过医疗补助计划获得保险、是否去急诊室就诊、是否至少看过一次医生、是否因费用而延迟治疗、是否因为无法负担而没有得到所需的治疗以及是否被医生办公室告知他们不接受你作为新病人。ACA 与一些群体的医疗保健获取和利用的增加有关,但在所有群体中都存在异质性。例如,一些移民群体的获取和利用率比其他群体更好,而公民身份群体之间也存在类似的差异。本研究强调了需要厘清政策如何影响来自世界不同地区的移民的重要性,这对医疗保健的利用和差异有影响。