Karimi Seyed M, Eslami Keyvan, Johnson Christopher E
J Health Care Poor Underserved. 2021;32(2):958-970. doi: 10.1353/hpu.2021.0074.
Health care expenditure (HCE) does not significantly vary by income in the U.S. However, health outcomes vary significantly by income. To understand the disconnection, we used the Medical Expenditure Panel Survey (MEPS) data and adjusted HCE for utilization and stratified it by income and age. We showed that the adjusted HCE is significantly higher among lower-income Americans, especially at older ages. At age 45-64, for example, the adjusted HCE for the poor, low-income, and high-income were $10,552; $7,118; and $5,300 in 2015 prices, respectively. We also found that children from lower-income families receive less nonurgent, preventive care than those from higher-income families. However, adults from lower-income families use much more urgent care than those from higher-income families. Our results, alongside the evidence of continuously widening gaps in mortality and morbidity rates among income groups, raise policy-relevant questions about the optimal age profile of health care provision, particularly among lower-income groups.
在美国，医疗保健支出（HCE）并不会因收入而有显著差异。然而，健康结果却因收入而有显著差异。为了理解这种脱节现象，我们使用了医疗支出面板调查（MEPS）数据，并对医疗保健支出进行了利用情况调整，然后按收入和年龄进行分层。我们发现，经调整后的医疗保健支出在低收入美国人中显著更高，尤其是在老年人群体中。例如，在45 - 64岁年龄段，按2015年价格计算，贫困、低收入和高收入人群的调整后医疗保健支出分别为10,552美元、7,118美元和5,300美元。我们还发现，低收入家庭的儿童比高收入家庭的儿童接受的非紧急预防性护理更少。然而，低收入家庭的成年人比高收入家庭的成年人使用的紧急护理要多得多。我们的研究结果，连同不同收入群体之间死亡率和发病率差距不断扩大的证据，引发了与政策相关的问题，即关于医疗保健提供的最佳年龄分布，特别是在低收入群体中。
