Key Provisions of the Patient Protection and Affordable Care Act (ACA): A Systematic Review and Presentation of Early Research Findings
Key Provisions of the Patient Protection and Affordable Care Act (ACA): A Systematic Review and Presentation of Early Research Findings
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DOI：
10.1111/1475-6773.12511
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发表时间：
2016-10-01
影响因子：
3.4
通讯作者：
Hickling, Lucas
中科院分区：
文献类型：
--
作者：
French, Michael T.;Homer, Jenny;Hickling, Lucas
目标。对《平价医疗法案》(ACA)中与扩大医疗保险覆盖范围有关的部分主要条款进行系统的文献审查。我们介绍和综合了过去5年关于ACA的短期和长期影响的研究结果。我们以总结结束，并为未来的研究提供一个研究议程。研究设计。我们通过对主要电子数据库进行全面搜索，从同行评议的学术期刊中确定了相关文章。我们还在政府机构和其他组织发布的灰色文献中确定了报告。总体而言，研究表明，ACA通过供养范围规定、医疗补助扩大、医疗保险交换、补贴的可获得性和其他政策变化，大幅减少了未参保个人的数量。医疗保险的可负担性仍然是许多人关切的问题，地理、种族/族裔和收入方面的差异依然存在。早期证据还表明，卫生保健的可及性和可负担性有所改善。所有这些变化最终肯定会影响州和联邦预算。ACA将直接或间接影响几乎所有美国人。随着新的全面数据的出现，更严格的评估将为ACA是否成功实现其目标提供进一步的见解。
Objectives. To conduct a systematic literature review of selected major provisions of the Affordable Care Act (ACA) pertaining to expanded health insurance coverage. We present and synthesize research findings from the last 5years regarding both the immediate and long-term effects of the ACA. We conclude with a summary and offer a research agenda for future studies.Study Design. We identified relevant articles from peer-reviewed scholarly journals by performing a comprehensive search of major electronic databases. We also identified reports in the gray literature disseminated by government agencies and other organizations.Principal Findings. Overall, research shows that the ACA has substantially decreased the number of uninsured individuals through the dependent coverage provision, Medicaid expansion, health insurance exchanges, availability of subsidies, and other policy changes. Affordability of health insurance continues to be a concern for many people and disparities persist by geography, race/ethnicity, and income. Early evidence also indicates improvements in access to and affordability of health care. All of these changes are certain to ultimately impact state and federal budgets.Conclusions. The ACA will either directly or indirectly affect almost all Americans. As new and comprehensive data become available, more rigorous evaluations will provide further insights as to whether the ACA has been successful in achieving its goals.