How Health Insurance Status Affects Persons with Disabilities

健康保险状况如何影响残疾人

• 批准号: 7194000
• 负责人: LISA I. IEZZONI
• 金额: $ 0.63万
• 依托单位: BETH ISRAEL DEACONESS MEDICAL CENTER
• 依托单位国家: 美国
• 财政年份: 2006
• 资助国家: 美国
• 起止时间: 2006-09-30 至 2006-10-01
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7194000
• 关键词: adult human (21+); clinical research; health insurance; health services research tag; human data; medically underserved population; person with disability

DESCRIPTION: Health insurance provides critical financial access to the U.S. health care system. In 2003, an estimated 45 million persons (15.6% of the population) lacked health insurance, generating enormous personal and societal costs related to diminished health and lowered life expectancies. Certain subpopulations are particularly susceptible to being uninsured. One such subgroup is working-age adults with disabilities that prevent them from "gainful" employment. According to the 2000 decennial census, 21.3 million persons (11.9%) age 16-64 report having some physical or mental condition that makes it hard for them to work. Recognizing their needs, social "safety net" health insurance programs target this population - Medicare and Medicaid, obtained after persons meet Social Security disability and other eligibility criteria. However, our preliminary analyses using the 2000 Medical Expenditure Panel Survey (MEPS) found that 18.7% of working-age persons reporting major sensory or physical disabilities (difficulties with vision, hearing, or using legs, arms, or hands) had no health insurance during some part of the prior year, compared with 14.7% of those without any such impairment. Nonetheless, on average, these individuals have greater health-related needs and generate higher costs than do other persons. The overall specific aims of this two-year study are to use MEPS data from 1998 through 2003 to: (1) explore fully the health insurance experiences of working age persons with sensory and physical impairments; and (2) examine how their health insurance status relates to service use, expenditures, access to and satisfaction with care, and self-reported health and functional outcomes. We shall focus on the Household Component portion of MEPS, which enrolls a nationally-representative sample of civilian, noninstitutionalized, U.S. residents and administers 5 rounds of surveys to them over 2 1/2 years. Using the richness of the data gathered by MEPS and its longitudinal design, we shall look also for trends over time in health insurance experiences for persons with sensory and physical impairments, as well as the consequences for individuals of transitioning on and off health insurance. Our ultimate goal is to use this information to improve the efficiency and quality of care provided to this potentially expensive population. This goal addresses the objectives of the Agency for Healthcare Research and Quality, which has identified persons with disabilities as one of its priority populations.

描述：健康保险为美国医疗保健系统提供了重要的财务渠道。2003年，估计有4 500万人（占人口的15.6%）没有医疗保险，造成了与健康下降和预期寿命缩短有关的巨大的个人和社会成本。某些亚群体特别容易没有保险。其中一个亚群是工作年龄的残疾成年人，他们无法获得“有酬”就业。根据2000年十年一次的人口普查，2 130万（11.9%）年龄在16-64岁之间的人报告说，他们的身体或精神状况使他们难以工作。认识到他们的需求，社会“安全网”健康保险计划针对这一人群-医疗保险和医疗补助，在人们满足社会保障残疾和其他资格标准后获得。然而，我们使用2000年医疗支出小组调查（MEPS）进行的初步分析发现，在报告有严重感官或身体残疾（视力、听力或使用腿、手臂或手的困难）的工作年龄人员中，18.7%在上一年的某个时候没有健康保险，而没有任何此类障碍的人中有14.7%。尽管如此，平均而言，这些人有更多的与健康有关的需求，产生的费用也比其他人高。这项为期两年的研究的总体具体目标是利用MEPS从1998年到2003年的数据：（1）充分探索有感官和身体障碍的工作年龄人员的健康保险经历;（2）检查他们的健康保险状况 与服务使用、支出、获得护理的机会和对护理的满意度以及自我报告的健康和功能结果有关。我们将重点关注MEPS的家庭组成部分，该部分招募了具有全国代表性的平民，非机构化的美国居民样本，并在2年半的时间内对他们进行了5轮调查。利用MEPS收集的丰富数据及其纵向设计，我们还将研究感官和身体障碍者的健康保险经历随时间的趋势，以及对个人过渡和关闭健康保险的后果。我们的最终目标是利用这些信息来提高为这一潜在昂贵人群提供的护理的效率和质量。这一目标涉及卫生保健研究和质量机构的目标，该机构已将残疾人确定为其优先群体之一。