Department of Health Management and Policy, Dornsife School of Public Health, Drexel University (S Park, JK Pintor, JP Stimpson, and AN Ortega), Philadelphia, Pa.
Department of Health Policy and Management, School of Public Health, University of Maryland (DH Roby and J Chen), College Park, Md.
Acad Pediatr. 2020 Jul;20(5):670-677. doi: 10.1016/j.acap.2019.11.004. Epub 2019 Nov 13.
We examined changes in insurance coverage and health care utilization associated with the Affordable Care Act (ACA) among subgroups of Asian youth relative to non-Latino white youth.
Data were from the 2010 to 2017 American Community Survey and National Health Interview Survey. Difference-in-difference models were used to examine changes in insurance coverage and health care utilization associated with the ACA among subgroups of Asian youth relative to white youth and subgroups of Asian youth in households below 200% of the federal poverty level relative to comparable white youth.
Since the implementation of the ACA, insurance coverage increased among all Asian subgroups and white youth. The magnitude of the increase in insurance coverage was larger among Asian subgroups than white youth. More pronounced increases were found among almost all Asian subgroups in households below 200% federal poverty level. Changes in health care utilization were limited and varied by subgroup. Increases in well-child visits were observed only among Chinese and "other" Asian youth.
Insurance coverage increased among Asian youth after the implementation of the ACA. Improvements in health care utilization were limited and differed by subgroups. Programs to improve health care utilization should be tailored to Asian youth according to subgroup.
我们考察了《平价医疗法案》(ACA)对亚裔青年群体和非拉丁裔白人青年群体的医疗保险覆盖范围和医疗保健利用的影响变化。
数据来源于 2010 年至 2017 年的美国社区调查和国家健康访谈调查。采用双重差分模型,考察了相对于白人青年群体,以及相对于收入水平低于联邦贫困线 200%的亚裔青年群体,《平价医疗法案》对不同亚裔青年群体的医疗保险覆盖范围和医疗保健利用的影响变化。
自 ACA 实施以来,所有亚裔青年群体和白人青年群体的医疗保险覆盖范围都有所增加。亚裔青年群体的保险覆盖范围增加幅度大于白人青年群体。在收入水平低于联邦贫困线 200%的家庭中,几乎所有亚裔青年群体的保险覆盖范围都有了更明显的增加。医疗保健利用的变化有限,且因亚组而异。只有中国裔和“其他”亚裔青年群体的儿童保健就诊次数有所增加。
ACA 实施后,亚裔青年群体的医疗保险覆盖范围有所增加。医疗保健利用的改善有限,且因亚组而异。根据亚组特点,应制定专门的计划来改善亚裔青年群体的医疗保健利用。