Health Insurance Affordability Concerns and Health Care Avoidance Among US Adults Approaching Retirement.
Health Insurance Affordability Concerns and Health Care Avoidance Among US Adults Approaching Retirement.
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DOI：
10.1001/jamanetworkopen.2019.20647
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发表时间：
2020-02-05
影响因子：
13.8
通讯作者：
Scherer, Aaron M.
中科院分区：
文献类型：
--
作者：
Tipirneni, Renuka;Solway, Erica;Malani, Preeti;Luster, Jamie;Kullgren, Jeffrey T.;Kirch, Matthias;Singer, Dianne;Scherer, Aaron M.
随着美国成年人在65岁时接近医疗保险资格，他们面临着关于医疗保健和就业的重要决定。最近的立法，监管和法律的挑战，以负担得起的医疗法案可能会增加新的不确定性，这一决策。了解成年人对健康保险，医疗保健和临近退休的就业的看法。2018年10月，进行了一项横断面在线调查，完成率= 62%。Ipsos KnowledgePanel®是一个全国性的互联网调查小组。社区居住的美国成年人，年龄50-64岁。对提供医疗保险的信心;保持工作或延迟退休以获得雇主赞助的医疗保险;担心由于联邦政策的变化而导致的医疗保险的潜在变化;以及由于成本而避免医疗保健或药物治疗。在1，028名受访者中，52%（95%CI 49%-55%）为女性，40%为高中或以下学历（95%CI 37%-44%），65%（95%CI 62%-68%）为在职人员，35%（95%CI 32%-38%）为退休或不工作人员。大约四分之一的受访者年龄在50-64岁之间（27%，95%CI 25%-30%）对明年能够负担健康保险几乎没有信心，近一半的人（45%，95%CI 41%-48%）对退休后支付医疗保险的能力几乎没有信心; 14%（95% CI 12%-17%）的人报告说，他们保留了一份工作或推迟或考虑推迟退休（11%，95% CI 10%-14%），以获得雇主赞助的医疗保险。大多数受访者（68%，95%CI 65%-71%）非常或有点担心由于联邦政策的变化而导致的健康保险的潜在变化。在过去的一年中，13%（95% CI 11%-16%）的人没有得到医疗护理，12%（95% CI 10%-14%）的人因为成本而避免服用处方药。在调整人口和健康特征后，对未来一年或退休后的医疗保险负担能力信心不足的人更有可能避免医疗保健（调整后比值比[aOR] 2.89，95% CI 11.86-4.49）和避免因成本问题而服用处方药（aOR 2.87，95% CI 1.71-4.80）。许多50-64岁的成年人担心他们在退休后负担医疗保险的能力，以及由于联邦政策的变化，他们的医疗保险选择未来可能发生的变化。需要政策解决方案来帮助患者更好地了解他们的覆盖范围选择，并在医疗保险资格之前的关键过渡期内导航医疗保健。
As U.S. adults approach Medicare eligibility at age 65, they face important decisions about health care and employment. Recent legislative, regulatory, and legal challenges to the Affordable Care Act may add new uncertainties to this decision-making. To understand adults’ perspectives on health insurance, health care, and employment near retirement. In October 2018, a cross-sectional online survey was conducted with completion rate=62%. Ipsos KnowledgePanel®, a nationally representative internet survey panel. Community-dwelling U.S. adults, age 50-64. Confidence in affording health insurance; keeping a job or delaying retirement to have employer-sponsored health insurance; concern about potential changes to health insurance due to changes in federal policies; and avoidance of medical care or medication due to cost. Among 1,028 respondents, 52% (95% CI 49%-55%) were female, 40% had high school education or less (95% CI 37%-44%), and 65% (95% CI 62%-68%) were employed while 35% (95% CI 32%-38%) were retired or not working. Approximately one-quarter of respondents age 50-64 (27%, 95% CI 25%-30%) had little to no confidence in being able to afford health insurance over the next year, and nearly half (45%, 95% CI 41%-48%) had little to no confidence in their ability to afford health insurance when they retire; 14% (95% CI 12%-17%) reported keeping a job or delaying or considered delaying retirement (11%, 95% CI 10%-14%) to have employer-sponsored health insurance. Most respondents (68%, 95% CI 65%-71%) were very or somewhat concerned about potential changes to their health insurance due to changes in federal policies. In the past year, 13% (95% CI 11%-16%) did not get medical care and 12% (95% CI 10%-14%) avoided filling a prescription medication because of cost. After adjusting for demographic and health characteristics, individuals with low confidence in health insurance affordability either in the next year or in retirement were significantly more likely to avoid medical care (adjusted odds radio [aOR] 2.89, 95% CI 11.86-4.49) and to avoid filling a prescription medication (aOR 2.87, 95% CI 1.71-4.80) because of cost concerns. Many adults age 50-64 worry about their ability to afford health insurance in retirement and about potential future changes to their health insurance options due to changes in federal policy. Policy solutions are needed to help patients better understand their coverage options and navigate health care in this critical transition period before Medicare eligibility.
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DOI：
10.1377/hlthaff.2008.0746
发表时间：
2010-04
期刊：
Health affairs (Project Hope)
影响因子：
--
作者：
Martin LG;Freedman VA;Schoeni RF;Andreski PM
通讯作者：
Andreski PM
影响因子：
4.5
作者：
Scharn M;Sewdas R;Boot CRL;Huisman M;Lindeboom M;van der Beek AJ
通讯作者：
van der Beek AJ
影响因子：
3.4
作者：
Callegaro, Mario;Disogra, Charles
通讯作者：
Disogra, Charles
影响因子：
120.7
作者：
Ayanian, JZ;Weissman, JS;Zaslavsky, AM
通讯作者：
Zaslavsky, AM
影响因子：
9.7
作者：
McWilliams, JM;Zaslavsky, AM;Ayanian, JZ
通讯作者：
Ayanian, JZ