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Association Between Prior Insurance and Health Service Utilization Among the Long-Term Uninsured in South Carolina

机译:南卡罗来纳州长期未保险者中先前保险与卫生服务利用之间的关联

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摘要

>Purpose: Strong evidence supports the relationship between health coverage and improved health status. Little is known about the lasting impact of prior health insurance on the prior insured's use of health services. We aimed to examine the association between prior insurance status and health service utilization (HSU) among the long-term uninsured (LTU) in South Carolina.>Methods: The current study used data from in-person interviews of the LTU collected in a 2014 cross-sectional South Carolina survey. Men and women between 18–64 years of age who reported not having health insurance for at least 24 months at the time of data collection were included. Propensity score analysis was used to examine the associations between prior insurance status and three outcome variables: (1) having a usual source of care, (2) HSU, and (3) delaying health care needs.>Results: Prior health insurance significantly predicted a greater likelihood of having a usual source of care (effect size: 9.2%, p=0.004) and having had at least one preventive visit during the past 2 years (effect size: 6.4%, p=0.035). Prior insurance coverage was positively associated with delayed health care utilization, but the result was not statistically significant (p=0.703).>Conclusions: Among the LTU, ever having insurance coverage was positively associated with having a usual source of care and HSU. The lasting impact of insurance coverage on HSU behavior extends beyond the period of insurance coverage, which provides a more comprehensive and deeper understanding of the long-term implications of national and local efforts in expanding insurance coverage.
机译:>目的:有力的证据支持健康覆盖率与健康状况改善之间的关系。关于事前医疗保险对事前被保险人使用医疗服务的持久影响知之甚少。我们旨在研究南卡罗来纳州长期未保险者(LTU)中以前的保险状况与健康服务利用(HSU)之间的关联。>方法:当前的研究使用的是来自LTU在2014年南卡罗来纳州横断面调查中收集。年龄在18-64岁之间的男性和女性在数据收集时报告了至少24个月没有医疗保险。倾向得分分析用于检查以前的保险状况与三个结果变量之间的关联:(1)具有通常的护理来源,(2)HSU,以及(3)延迟医疗需求。>结果:先前的健康保险显着预测了更有可能获得常规护理(影响量:9.2%,p = 0.004),并且在过去两年中至少进行了一次预防性拜访(影响量:6.4%,p = 0.035) )。先前的保险覆盖率与延迟使用医疗保健呈正相关,但结果在统计学上不显着(p = 0.703)。>结论:在LTU中,曾经有保险覆盖率与通常的来源呈正相关和HSU保险范围对HSU行为的持久影响超出了保险范围,它使人们更全面,更深入地了解了国家和地方在扩大保险范围方面所做的长期努力。

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