Novak Priscilla J, Ali Mir M, Sanmartin Maria X
Department of Health Policy and Management, School of Public Health, University of Maryland at College Park, College Park, Maryland, USA.
Department of Health Professions, Hofstra University, Hempstead, New York, USA.
Health Equity. 2020 Dec 30;4(1):549-555. doi: 10.1089/heq.2020.0090. eCollection 2020.
To examine indebtedness for medical care among racial and ethnic minorities and people with serious psychological distress (SPD) using a nationally representative sample in the United States. Using the 2014-2017 Medical Expenditure Panel Survey, we examine medical debt among individuals with SPD. We develop a logistic regression model to estimate the odds of medical debt by SPD status. We stratify the odds of medical debt for those with SPD by insurance type. The results indicate that after controlling for predisposing, enabling, and physical needs factors, those experiencing SPD have double the odds of having medical debt compared with those without SPD. Non-Hispanic blacks had higher odds of medical debt compared with non-Hispanic whites. We find that individuals with SPD covered under private health insurance have double the odds of having medical debts; and those who are uninsured have triple the odds of having medical debt compared with their counterparts without SPD. The findings suggest that odds of medical debt are higher among people with SPD, even when insured. Additional health policy initiatives to address medical debt among those with SPD may be warranted.
在美国，使用具有全国代表性的样本，研究少数族裔和患有严重心理困扰（SPD）的人群的医疗债务情况。利用2014 - 2017年医疗支出面板调查，我们研究了患有SPD的个体的医疗债务。我们建立了一个逻辑回归模型来估计因SPD状况而产生医疗债务的几率。我们按保险类型对患有SPD的人群的医疗债务几率进行分层。结果表明，在控制了 predisposing、enabling 和身体需求因素后，患有SPD的人群产生医疗债务的几率是未患SPD人群的两倍。与非西班牙裔白人相比，非西班牙裔黑人产生医疗债务的几率更高。我们发现，参加私人医疗保险的患有SPD的个体产生医疗债务的几率是未患SPD的对应个体的两倍；而未参保的个体产生医疗债务的几率是未患SPD的对应个体的三倍。研究结果表明，即使参保，患有SPD的人群产生医疗债务的几率也更高。可能需要采取额外的卫生政策举措来解决患有SPD的人群的医疗债务问题。
