Health Insurance Coverage and Medical Expenditures of Immigrants and Native-Born Citizens in the United States
Health Insurance Coverage and Medical Expenditures of Immigrants and Native-Born Citizens in the United States
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DOI：
10.2105/ajph.2008.144733
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发表时间：
2009-07-01
影响因子：
12.7
通讯作者：
Ku, Leighton
中科院分区：
文献类型：
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作者：
Ku, Leighton
目标.我检查了移民和美国出生的成年人的保险范围和医疗支出，以确定移民在多大程度上有助于美国的医疗支出。我使用2003年医疗支出面板调查的数据进行医疗支出的两部分多变量分析，控制健康状况，保险范围，种族/民族，和其他社会人口因素。在12个月的分析期内，大约44%的新移民和63%的老移民都有充分的保险。移民的人均未经调整的医疗支出大约是美国出生的支出的一半到三分之二，即使移民有充分的保险。新移民只占公共医疗支出的1%，尽管他们占人口的5%。在控制了其他因素后，我发现移民的医疗费用平均比美国人少14%到20%。即使在保险覆盖的影响得到控制之后，投保移民的医疗费用也比投保的美国出生公民低得多。这表明，移民的保险费可能是对美国出生的人的交叉补贴。如果是这样的话，医疗资源可以重新分配给移民，以改善他们的护理。(Am J公共卫生。2009;99：1322-1328. doi：10.2105/AJPH.2008.144733）
Objectives. I examined insurance coverage and medical expenditures of both immigrant and US-born adults to determine the extent to which immigrants contribute to US medical expenditures.Methods. I used data from the 2003 Medical Expenditure Panel Survey to perform 2-part multivariate analyses of medical expenditures, controlling for health status, insurance coverage, race/ethnicity, and other sociodemographic factors.Results. Approximately 44% of recent immigrants and 63% of established immigrants were fully insured over the 12-month period analyzed. Immigrants' per-person unadjusted medical expenditures were approximately one half to two thirds as high as expenditures for the US born, even when immigrants were fully insured. Recent immigrants were responsible for only about 1% of public medical expenditures even though they constituted 5% of the population. After controlling for other factors, I found that immigrants' medical costs averaged about 14% to 20% less than those who were US born.Conclusions. Insured immigrants had much lower medical expenses than insured US-born citizens, even after the effects of insurance coverage were controlled. This suggests that immigrants' insurance premiums may be cross-subsidizing care for the US-born. If so, health care resources could be redirected back to immigrants to improve their care. (Am J Public Health. 2009;99:1322-1328. doi:10.2105/AJPH.2008.144733)