Norris Hope C, Richardson Haley M, Benoit Marie-Anais C, Shrosbree Beth, Smith Judith E, Fendrick A Mark
The University of Michigan, Ann Arbor, MI, USA.
New York University, New York, NY, USA.
Med Care Res Rev. 2022 Apr;79(2):175-197. doi: 10.1177/10775587211027372. Epub 2021 Jun 22.
Consumer cost-sharing has been shown to diminish utilization of preventive services. Recent efforts, including provisions within the Affordable Care Act, have sought to increase use of preventive care through elimination of cost-sharing for clinically indicated services. We conducted a rapid review of the literature to determine the impact of cost-share elimination on utilization of preventive services. Searches were conducted in PubMed, Scopus, and CINAHL Complete databases as well as in grey literature. A total of 35 articles were included in qualitative synthesis and findings were summarized for three clinical service categories: cancer screenings, contraceptives, and additional services. Impacts of cost-sharing elimination varied depending on clinical service, with a majority of findings showing increases in use. Studies that included socioeconomic status reported that those who were financially vulnerable incurred substantial increases in utilization. Future investigations on additional clinical services are warranted as is research to better elucidate populations who most benefit from cost-sharing elimination.
消费者成本分担已被证明会减少预防性服务的使用。最近的一些举措，包括《平价医疗法案》中的相关规定，试图通过消除临床推荐服务的成本分担来增加预防性护理的使用。我们对文献进行了快速回顾，以确定消除成本分担对预防性服务使用的影响。在PubMed、Scopus和CINAHL Complete数据库以及灰色文献中进行了检索。共有35篇文章纳入定性综合分析，并针对癌症筛查、避孕药具和其他服务这三个临床服务类别总结了研究结果。消除成本分担的影响因临床服务而异，大多数研究结果显示使用量增加。纳入社会经济地位因素的研究报告称，经济上脆弱的人群使用量大幅增加。有必要对更多临床服务进行未来调查，同时也需要开展研究以更好地阐明最能从消除成本分担中受益的人群。
