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保险扩张与青少年物质使用障碍治疗的使用。

Insurance expansions and adolescent use of substance use disorder treatment.

机构信息

Department of Public Administration and International Affairs, Syracuse University, Syracuse, New York, USA.

Center for Policy Research, Syracuse, New York, USA.

出版信息

Health Serv Res. 2021 Apr;56(2):256-267. doi: 10.1111/1475-6773.13604. Epub 2020 Nov 18.

Abstract

OBJECTIVE

To provide evidence on the effects of expansions to private and public insurance programs on adolescent specialty substance use disorder (SUD) treatment use.

DATA SOURCE/STUDY SETTING: The Treatment Episodes Data Set (TEDS), 1996 to 2017.

STUDY DESIGN

A quasi-experimental difference-in-differences design using observational data.

DATA COLLECTION

The TEDS provides administrative data on admissions to specialty SUD treatment.

PRINCIPAL FINDINGS

Expansions of laws that compel private insurers to cover SUD treatment services at parity with general health care increase adolescent admissions by 26% (P < .05). These increases are driven by nonintensive outpatient admissions, the most common treatment episodes, which rise by 30% (P < .05) postparity law. In contrast, increases in income eligibility for public insurance targeting those 6-18 years old are not statistically associated with SUD treatment.

CONCLUSIONS

Private insurance expansions allow more adolescents to receive SUD treatment, while public insurance income eligibility expansions do not appear to influence adolescent SUD treatment.

摘要

目的

为评估私人保险和公共保险计划的扩张对青少年专业物质使用障碍(SUD)治疗使用的影响提供证据。

数据来源/研究环境:治疗发作数据集中(TEDS),1996 年至 2017 年。

研究设计

使用观察性数据的准实验差分设计。

数据收集

TEDS 提供了有关专业 SUD 治疗入院的行政数据。

主要发现

迫使私人保险公司将 SUD 治疗服务覆盖范围与一般医疗保健相媲美的法律的扩展使青少年入院率增加了 26%(P<0.05)。这些增加是由最常见的治疗案例非强化门诊治疗引起的,该治疗案例在均等法律后增加了 30%(P<0.05)。相比之下,针对 6-18 岁人群的公共保险收入资格扩大与 SUD 治疗没有统计学关联。

结论

私人保险的扩张使更多的青少年能够接受 SUD 治疗,而公共保险收入资格的扩大似乎并不影响青少年 SUD 治疗。

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