Medical expenditures among immigrant and nonimmigrant groups in the United States: findings from the Medical Expenditures Panel Survey (2000-2008).
Medical expenditures among immigrant and nonimmigrant groups in the United States: findings from the Medical Expenditures Panel Survey (2000-2008).
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DOI：
10.1097/mlr.0b013e318241e5c2
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发表时间：
2012-03
期刊：
影响因子：
3
通讯作者：
González HM
中科院分区：
文献类型：
--
作者：
Tarraf W;Miranda PY;González HM
为了研究非公民，外国出生和美国之间医疗支出的时间趋势和差异，天生的公民我们使用了多年的医疗支出小组调查（2000-2008）数据，在美国非机构化的成年人（N= 190，965）。使用回归模型，自助预测技术，线性和非线性分解方法，以评估移民身份和支出之间的关系，控制混杂效应的来源具体和总医疗支出进行了分析。我们发现，2000年至2008年期间，非公民移民的平均医疗支出（1，836美元）远低于外国出生的（3，737美元）和美国-出生公民（$4，478）。在控制混杂效应后，差异仍保持不变。分解技术表明，这些差异的主要决定因素是一个通常的医疗保健，保险和民族/种族来源的可用性。移民的医疗保健支出较低是由于获得医疗保健的机会不同。随着移民年龄的增长和慢性病水平的上升，移民人口优势的消失可能会给美国医疗保健系统带来更大的压力。除非政策发生转变，否则首当其冲的影响可能会由已经过度扩张的公共医疗体系承担。
To examine time trends and differences in medical expenditures between non-citizens, foreign-born, and U.S.-born citizens. We used multi-year Medical Expenditures Panel Survey (2000–2008) data on non-institutionalized adults in the U.S. (N=190,965). Source specific and total medical expenditures were analyzed using regression models, bootstrap prediction techniques, and linear and non-linear decomposition methods to evaluate the relationship between immigration status and expenditures, controlling for confounding effects. We found that the average health expenditures between 2000 and 2008 for non-citizens immigrants ($1,836) were substantially lower compared to both foreign-born ($3,737) and U.S.-born citizens ($4,478). Differences were maintained after controlling for confounding effects. Decomposition techniques showed that the main determinants of these differences were the availability of a usual source of healthcare, insurance, and ethnicity/race. Lower healthcare expenditures among immigrants result from disparate access to healthcare. The dissipation of demographic advantages among immigrants could prospectively produce higher pressures on the U.S. healthcare system as immigrants age and levels of chronic conditions rise. Barring a shift in policy, the brunt of the effects could be borne by an already overextended public healthcare system.