Kirk Kerkorian School of Medicine at UNLV, Las Vegas, USA.
Keck School of Medicine of University of Southern California, Los Angeles, USA.
BMC Health Serv Res. 2024 Nov 29;24(1):1504. doi: 10.1186/s12913-024-11992-z.
Psoriasis is a chronic, inflammatory skin condition requiring long-term care. However, many psoriasis patients may not regularly receive care. Several factors affect access to care in the United States, including health insurance status. Additionally, it is unknown how health insurance status impacts the healthcare-seeking behavior of psoriasis patients. Healthcare-seeking behavior is broadly defined as an individual's actions to prevent or treat a perceived health problem, such as visiting a physician's office. Because early diagnosis and timely treatment improve patient outcomes, determining how insurance status impacts psoriasis patients' healthcare-seeking behavior and their ability to get care is important. This allows us to identify patients at risk for being untreated or undertreated. In this study, we aimed to assess the relationship between insurance status and (1) the degree to which psoriasis patients delay seeking or receiving care and (2) the degree to which psoriasis patients are unable to obtain care.
This population-based study used 20 years of data from the Medical Expenditure Panel Survey from 2002 to 2021. We calculated descriptive statistics and performed adjusted multivariable logistic regression analyses.
We identified a weighted total of 4,506,850 psoriasis patients. Compared to those with private insurance, psoriasis patients with public-only insurance were 2.7 times more likely to delay seeking or receiving care (95% CI, 1.26-5.87). Compared to private insurance patients, uninsured psoriasis patients were 3.4 times more likely to be unable to obtain care (95% CI, 1.31-8.92). Compared to those with public-only insurance, uninsured psoriasis patients were 3.7 times more likely to be unable to obtain care (95% CI, 1.32-10.38).
This study found that psoriasis patients with public-only insurance were significantly more likely to delay seeking or receiving care compared to those with private insurance. This study also found that uninsured psoriasis patients were significantly more likely to be unable to obtain care than psoriasis patients with private insurance and those with public-only insurance. Developing strategies to increase healthcare access is necessary to ensure equitable, timely, and appropriate care for all psoriasis patients, regardless of their insurance status.
银屑病是一种慢性炎症性皮肤病，需要长期护理。然而，许多银屑病患者可能无法定期接受护理。在美国，有几个因素会影响获得护理的机会，包括健康保险状况。此外，尚不清楚健康保险状况如何影响银屑病患者的就医行为。就医行为广泛定义为个人为预防或治疗感知到的健康问题而采取的行动，例如去看医生办公室。因为早期诊断和及时治疗可以改善患者的预后，所以确定保险状况如何影响银屑病患者的就医行为及其获得护理的能力非常重要。这可以帮助我们识别出未得到治疗或治疗不足的患者。在这项研究中，我们旨在评估保险状况与（1）银屑病患者延迟寻求或接受护理的程度以及（2）银屑病患者无法获得护理的程度之间的关系。
本基于人群的研究使用了 2002 年至 2021 年期间 20 年的医疗支出面板调查数据。我们计算了描述性统计数据，并进行了调整后的多变量逻辑回归分析。
我们确定了总计 4506850 例银屑病患者。与拥有私人保险的患者相比，仅拥有公共保险的银屑病患者延迟寻求或接受护理的可能性高 2.7 倍（95%置信区间，1.26-5.87）。与私人保险患者相比，没有保险的银屑病患者无法获得护理的可能性高 3.4 倍（95%置信区间，1.31-8.92）。与仅拥有公共保险的患者相比，没有保险的银屑病患者无法获得护理的可能性高 3.7 倍（95%置信区间，1.32-10.38）。
这项研究发现，仅拥有公共保险的银屑病患者与拥有私人保险的患者相比，更有可能延迟寻求或接受护理。这项研究还发现，与拥有私人保险和仅拥有公共保险的银屑病患者相比，没有保险的银屑病患者无法获得护理的可能性更高。制定增加医疗保健机会的策略对于确保所有银屑病患者，无论其保险状况如何，都能获得公平、及时和适当的护理是必要的。
