Bazzoli G J
Health Serv Res. 1986 Aug;21(3):353-93.
Health care for the indigent is a major problem in the United States. This review of the literature on health care for the indigent was undertaken to determine which major questions remain unresolved. Overall, this article finds that a very large pool of individuals under age 65 are at risk of being medically indigent. A myriad of health programs for some economically disadvantaged individuals do exist, but their level of funding has fluctuated over time--and many poor individuals must rely entirely on the generosity of a relatively small number of hospitals and other providers for their care. Economic pressures on these providers as well as structural changes in the health care sector can only adversely affect the amount of charity care that they offer. It is clear that a well-planned solution to indigent care in the United States, rather than a piecemeal approach, is needed.
为贫困人群提供医疗保健服务是美国面临的一个重大问题。开展此次对贫困人群医疗保健相关文献的综述,旨在确定哪些主要问题仍未得到解决。总体而言,本文发现大量65岁以下的人群有陷入医疗贫困的风险。确实存在针对一些经济弱势群体的众多医疗项目,但其资金水平随时间波动——许多贫困个体必须完全依赖相对少数的医院和其他医疗服务提供者的慷慨救助来获得治疗。这些医疗服务提供者面临的经济压力以及医疗保健行业的结构变化只会对他们提供的慈善医疗数量产生不利影响。显然,美国需要一个精心规划的贫困医疗保健解决方案,而不是零敲碎打的方法。