Determinants of facilitated health insurance enrollment for patients with HIV disease, and impact of insurance enrollment on targeted health outcomes.
Determinants of facilitated health insurance enrollment for patients with HIV disease, and impact of insurance enrollment on targeted health outcomes.
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DOI：
10.1186/s12879-018-3035-7
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发表时间：
2018-03-16
影响因子：
3.7
通讯作者：
Swindells S
中科院分区：
文献类型：
--
作者：
Furl R;Watanabe-Galloway S;Lyden E;Swindells S
《平价医疗法》（ACA）的出台为没有保险的艾滋病毒感染者提供了前所未有的机会，使他们能够获得医疗保险，并审查这种变化对获得医疗保险的影响。艾滋病药物援助计划（ADAP）已被指示追求未投保的个人参加ACA作为一种节省成本的战略，并增加病人获得护理。我们评估了ADAP促进的健康保险登记对健康结果的影响，以及影响合格患者是否登记的人口统计学和临床因素。在ACA的首次开放注册期间，284名内布拉斯加州ADAP接受者获得了保险注册; 139人注册，145人没有。进行了比较和多变量模型的开发考虑到与注册和投保和未投保群体之间的差异相关的因素。在控制其他变量后，保险登记与改善的健康结果相关，并且与不可检测的病毒血症（治疗成功的关键指标）显著相关（p < .0001）。我们发现，少数民族和居住不稳定的个人不参加保险的风险增加。《国家艾滋病毒/艾滋病战略》呼吁采取新的干预措施，改善不成比例受影响人口的艾滋病毒健康结果。这项研究提供了证据，优先考虑未来的ADAP促进保险登记战略，以达到少数民族人口和不稳定的住房个人。
The introduction of the Affordable Care Act (ACA) has provided unprecedented opportunities for uninsured people with HIV infection to access health insurance, and to examine the impact of this change in access. AIDS Drug Assistance Programs (ADAPs) have been directed to pursue uninsured individuals to enroll in the ACA as both a cost-saving strategy and to increase patient access to care. We evaluated the impact of ADAP-facilitated health insurance enrollment on health outcomes, and demographic and clinical factors that influenced whether or not eligible patients enrolled. During the inaugural open enrollment period for the ACA, 284 Nebraska ADAP recipients were offered insurance enrollment; 139 enrolled and 145 did not. Comparisons were conducted and multivariate models were developed considering factors associated with enrollment and differences between the insured and uninsured groups. Insurance enrollment was associated with improved health outcomes after controlling for other variables, and included a significant association with undetectable viremia, a key indicator of treatment success (p < .0001). We found that minority populations and unstably housed individuals were at increased risk to not enroll in insurance. The National HIV/AIDS Strategy calls for new interventions to improve HIV health outcomes for disproportionately impacted populations. This study provides evidence to prioritize future ADAP-facilitated insurance enrollment strategies to reach minority populations and unstably housed individuals.
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DOI：
10.1097/qai.0000000000000251
发表时间：
2014-09-01
期刊：
Journal of acquired immune deficiency syndromes (1999)
影响因子：
--
作者：
Yehia BR;Fleishman JA;Agwu AL;Metlay JP;Berry SA;Gebo KA;HIV Research Network
通讯作者：
HIV Research Network
影响因子：
11.8
作者：
McManus, Kathleen A.;Rhodes, Anne;Dillingham, Rebecca
通讯作者：
Dillingham, Rebecca
DOI：
10.1198/016214501753208582
发表时间：
2001-09-01
影响因子：
3.7
作者：
Goldman, DR;Bhattacharya, J;Morton, SC
通讯作者：
Morton, SC
影响因子：
11.8
作者：
Aberg, Judith A.;Gallant, Joel E.;Horberg, Michael A.
通讯作者：
Horberg, Michael A.
影响因子：
39
作者：
Hall, H. Irene;Frazier, Emma L.;Skarbinski, Jacek
通讯作者：
Skarbinski, Jacek