Encouraging Preventive Services for Low-Income Children: The Effect of Expanding Medicaid
Encouraging Preventive Services for Low-Income Children: The Effect of Expanding Medicaid
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鼓励低收入儿童的预防服务：扩大医疗补助的影响
DOI：
10.1097/00005650-199209000-00002
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发表时间：
1992
期刊：
影响因子：
3
通讯作者：
D. Lefkowitz
中科院分区：
文献类型：
--
作者：
P. F. Short;D. Lefkowitz
自1984年以来，国会每年都扩大医疗补助计划，以覆盖越来越多的低收入儿童。在这项研究中，一个多变量分析的数据，从1987年全国医疗支出调查，以确定是否扩大医疗补助资格可能是有效的，鼓励推荐的预防性访问低收入，学龄前儿童。对于那些没有保险的低收入儿童来说，一整年的医疗补助使任何健康儿童就诊的概率增加了17个百分点，并且遵守美国儿科学会关于健康儿童就诊的指南增加了13个百分点。慷慨的医疗补助费用并没有改变这些影响的程度。然而，即使所有贫困线200%以下的无保险儿童都有资格获得医疗补助，低收入儿童在使用预防服务方面仍将落后于其他儿童。除了保险和收入以外的因素，如低收入母亲的教育程度较低，造成了200%以上和200%以下儿童之间约80%的差距。所有学龄前儿童对美国儿科学会指南的依从率低于50%。建议的访视时间表的缺陷在生命的第二年特别明显，可能会干扰儿童及时接受建议的免疫接种。
Every year since 1984, Congress has expanded Medicaid to cover an increasing proportion of low-income children. In this study, a multivariate analysis of data from the 1987 National Medical Expenditure Survey was used to determine whether expanded Medicaid eligibility is likely to be effective in encouraging recommended preventive visits for low-income, preschool children. For low-income children who would otherwise be uninsured, a full year of Medicaid increased the probability of any well-child visits by 17 percentage points, and compliance with the guidelines of the American Academy of Pediatrics for well-child visits increased by 13 percentage points. The generosity of Medicaid fees did not alter the magnitude of these effects. However, even if all uninsured children under 200% of the poverty line were eligible for Medicaid, low-income children would continue to lag behind other children in their use of preventive services. Factors other than insurance and income, such as the lower educational attainment of low-income mothers, explain approximately 80% of the gap between children above and below 200% of poverty. The rate of compliance with the American Academy of Pediatrics guidelines was less than 50% for all preschool children. Departures from the recommended schedule of visits were particularly pronounced in the second year of life and may interfere with children receiving the recommended immunizations in a timely manner.