ST. LOUIS, MISSOURI.
Trans Am Clin Climatol Assoc. 2024;134:200-213.
Despite higher per-capita health care spending than any other country, the United States lags far behind in health outcomes. Additionally, there are significant health inequities by race, ethnicity, socioeconomic position, and rurality. One set of potential solutions to improve these outcomes and reduce inequities is through health policy. Policy focused on improving access to care through insurance coverage, such as the Affordable Care Act's Medicaid expansion, has led to better health and reduced mortality. Policy aimed at improving health care delivery, including value-based payment and alternative payment models, has improved quality of care but has had little impact on population health outcomes. Policies that influence broader issues of economic opportunity likely have a strong influence on health, but lack the evidence base of more targeted interventions. To advance health outcomes and equity, further policy change is crucial.
尽管美国的人均医疗保健支出高于其他任何国家，但在医疗效果方面却远远落后。此外，在种族、民族、社会经济地位和农村地区方面存在着显著的健康不平等。通过医疗政策来改善这些结果和减少不平等是潜在的解决方案之一。政策侧重于通过保险覆盖范围来改善获得医疗保健的机会，例如《平价医疗法案》（Affordable Care Act）的医疗补助扩大计划，这已经导致了更好的健康状况和更低的死亡率。旨在改善医疗保健提供方式的政策，包括基于价值的支付和替代支付模式，已经改善了医疗质量，但对人口健康结果几乎没有影响。影响更广泛经济机会问题的政策可能对健康有很大影响，但缺乏更有针对性干预措施的证据基础。为了改善健康结果和公平性，进一步的政策变革至关重要。
