Medical Bankruptcy in Massachusetts: Has Health Reform Made a Difference?
Medical Bankruptcy in Massachusetts: Has Health Reform Made a Difference?
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DOI：
10.1016/j.amjmed.2010.11.009
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发表时间：
2011-03-01
影响因子：
5.9
通讯作者：
Woolhandler, Steffie
中科院分区：
文献类型：
--
作者：
Himmelstein, David U.;Thorne, Deborah;Woolhandler, Steffie
背景：马萨诸塞州最近的医疗改革减少了没有保险的人数，但没有研究检查了医疗破产率前后的改革实施。方法：2009年，我们调查了199名马萨诸塞州破产申请人的财务崩溃的医疗前因，使用了与2007年全国2314名债务人调查相同的问题，其中包括马萨诸塞州的44名。我们根据债务人陈述的破产原因、因疾病造成的收入损失以及医疗债务的规模，将破产定义为“医疗”破产。结果：2009年，疾病和医疗费用占马萨诸塞州破产的52.9%，而2007年该州破产的59.3% (P = 0.44)， 2007年全国破产的62.1% （P < .02）。2007年至2009年间，马萨诸塞州的破产申请总数增加了51%，略低于全国平均水平。（在其他93个破产区中，马萨诸塞州的增幅低于54个。）总体而言，马萨诸塞州医疗破产的总数在此期间增加了三分之一以上。2009年，89%的债务人及其所有家属在提交申请时都有医疗保险，而四分之一的破产家庭最近失去了医疗保险。结论：马萨诸塞州的医疗改革并没有减少医疗破产的数量，尽管改革前后该州的医疗破产率都低于全国的医疗破产率。(C) 2011爱思唯尔公司版权所有。《美国医学杂志》（2011）124,224-228
BACKGROUND: Massachusetts' recent health reform has decreased the number of uninsured, but no study has examined medical bankruptcy rates before and after the reform was implemented.METHODS: In 2009, we surveyed 199 Massachusetts bankruptcy filers regarding medical antecedents of their financial collapse using the same questions as in a 2007 survey of 2314 debtors nationwide, including 44 in Massachusetts. We designated bankruptcies as "medical" based on debtors' stated reasons for filing, income loss due to illness, and the magnitude of their medical debts.RESULTS: In 2009, illness and medical bills contributed to 52.9% of Massachusetts bankruptcies, versus 59.3% of the bankruptcies in the state in 2007 (P = .44) and 62.1% nationally in 2007 (P < .02). Between 2007 and 2009, total bankruptcy filings in Massachusetts increased 51%, an increase that was somewhat less than the national norm. (The Massachusetts increase was lower than in 54 of the 93 other bankruptcy districts.) Overall, the total number of medical bankruptcies in Massachusetts increased by more than one third during that period. In 2009, 89% of debtors and all their dependents had health insurance at the time of filing, whereas one quarter of bankrupt families had experienced a recent lapse in coverage.CONCLUSION: Massachusetts' health reform has not decreased the number of medical bankruptcies, although the medical bankruptcy rate in the state was lower than the national rate both before and after the reform. (C) 2011 Elsevier Inc. All rights reserved. . The American Journal of Medicine (2011) 124, 224-228