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医疗保险优势计划参保者关于医疗服务过程中受到不公平待遇的报告。

Medicare Advantage enrollees' reports of unfair treatment during health care encounters.

作者信息

Mathews Megan, Beckett Megan K, Martino Steven C, Brown Julie A, Orr Nate, Gaillot Sarah, Elliott Marc N

机构信息

RAND Corporation, Arlington, VA 22202, United States.

RAND Corporation, Santa Monica, CA 90401, United States.

出版信息

Health Aff Sch. 2024 May 29;2(5):qxae063. doi: 10.1093/haschl/qxae063. eCollection 2024 May.

Abstract

We investigated unfair treatment among 1863 Medicare Advantage (MA) enrollees from 21 MA plans using 2022 survey data (40% response rate) in which respondents indicated whether they were treated unfairly in a health care setting based on any of 10 personal characteristics. We calculated reported unfair treatment rates overall and by enrollee characteristics. Nine percent of respondents reported any unfair treatment, most often based on health condition (6%), disability (3%), or age (2%). Approximately 40% of those reporting any unfair treatment endorsed multiple categories. People who qualified for Medicare via disability reported unfair treatment by disability, age, income, race and ethnicity, sex, sexual orientation, and gender/gender identity more often than those who qualified via age. Enrollees dually eligible for Medicare and Medicaid or eligible for a Low-Income Subsidy (DE/LIS) reported unfair treatment by disability, income, language/accent, race and ethnicity, culture/religion, and sex more often than non-DE/LIS enrollees. Compared with White respondents, racial and ethnic minority respondents more often reported unfair treatment by race and ethnicity, language/accent, culture/religion, and income. Female respondents were more likely than male respondents to report unfair treatment based on age and sex.

摘要

我们利用2022年的调查数据(回复率为40%),对来自21个医疗保险优势(MA)计划的1863名MA参保者中的不公平待遇情况进行了调查。在该调查中,受访者需表明他们在医疗环境中是否因10种个人特征中的任何一种而受到不公平对待。我们计算了总体以及按参保者特征划分的报告不公平待遇率。9%的受访者报告了任何不公平待遇,最常见的是基于健康状况(6%)、残疾(3%)或年龄(2%)。在报告了任何不公平待遇的人中,约40%认可多个类别。通过残疾资格获得医疗保险的人比通过年龄资格获得医疗保险的人更常报告在残疾、年龄、收入、种族和族裔、性别、性取向以及性别/性别认同方面受到不公平待遇。同时符合医疗保险和医疗补助资格或符合低收入补贴资格(双重资格/低收入补贴,DE/LIS)的参保者比非DE/LIS参保者更常报告在残疾、收入、语言/口音、种族和族裔、文化/宗教以及性别方面受到不公平待遇。与白人受访者相比,少数族裔受访者更常报告在种族和族裔、语言/口音、文化/宗教以及收入方面受到不公平待遇。女性受访者比男性受访者更有可能报告基于年龄和性别的不公平待遇。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/58b1/11135643/a126bc753aad/qxae063f1.jpg

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