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医疗补助扩张对扩张州和非扩张州的医疗保健服务获取、健康行为和健康结果的影响。

The effect of medicaid expansion on access to healthcare, health behaviors and health outcomes between expansion and non-expansion states.

机构信息

University of Texas at San Antonio, College for Health, Community, and Policy, Department of Public Administration, USA.

University of Texas at San Antonio, College for Health, Community, and Policy, Department of Public Administration, USA.

出版信息

Eval Program Plann. 2023 Aug;99:102304. doi: 10.1016/j.evalprogplan.2023.102304. Epub 2023 May 6.

Abstract

In 1965, Medicaid was implemented with the goal of providing insurance to low-income individuals. In 2010, the Patient Protection Affordable Care Act (PPACA) standardized and expanded the eligibility criteria for the Medicaid program across the United States. In 2012, the constitutionality of this expansion was challenged and the Supreme Court rules that states were only required to expand their Medicaid program if they wanted to utilize the additional funds allotted by the federal government. This research paper examines the effects of the expansion by looking at health data in expansion and non-expansion states. Specifically, this study compares metrics designed to gauge healthcare access, health behaviors and health outcomes to determine if expansion has had positive overall effect on expansion states. We conclude that expansion states have demonstrated improved access to healthcare and improved health outcomes than the non-expansion states. Changes in health behaviors reflect mixed results - HIV screenings are higher in expansion states but participation in flu vaccinations show no statistical significance difference between the two groups. Given the results of this analysis, we conclude that Medicaid expansion is an effective policy for states to pursue in order to further the original objectives of Medicaid by improving the health of low-income recipients.

摘要

1965 年,医疗补助计划(Medicaid)实施,旨在为低收入个人提供保险。2010 年,《平价医疗法案》(Patient Protection Affordable Care Act,PPACA)规范并扩大了全美医疗补助计划的资格标准。2012 年,该计划的扩张性被质疑,最高法院裁定各州只有在希望利用联邦政府分配的额外资金时才需要扩大其医疗补助计划。本研究论文通过考察扩张计划对扩张州和非扩张州的健康数据的影响来研究这一扩张计划的效果。具体来说,本研究通过比较旨在衡量医疗保健可及性、健康行为和健康结果的指标,来确定扩张计划是否对扩张州产生了积极的总体影响。我们的结论是,扩张州在医疗保健可及性和健康结果方面都表现出了改善,而不是扩张州。健康行为的变化反映出好坏参半的结果——扩张州的 HIV 筛查率较高,但流感疫苗接种率在两组之间没有统计学意义上的差异。鉴于这一分析的结果,我们得出结论,医疗补助计划的扩张是各州为了进一步实现医疗补助计划的最初目标,即改善低收入受益人的健康而采取的一项有效政策。

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