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首页> 外文期刊>Preventive Medicine: An International Journal Devoted to Practice and Theory >Effects of the Affordable Care Act's enhancement of Medicare benefits on preventive services utilization among older adults in the US
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Effects of the Affordable Care Act's enhancement of Medicare benefits on preventive services utilization among older adults in the US

机译：实惠护理法对美国老年人预防服务利用的提高的影响

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Since 2011, the Affordable Care Act (ACA) requires the provision of certain recommended clinical preventive services without cost-sharing for individuals in Medicare. We re-visited the effects of the ACA on preventive services utilization under Medicare, using data from the Medical Expenditure Panel Survey (MEPS) and examined the ACA's longer-term effects on preventive services utilization among Medicare beneficiaries. We analyzed nationally representative data on non-institutionalized Medicare beneficiaries (n = 27,124) from the 2006-2010 and 2012-2016 Medical Expenditure Panel Survey. Preventive services of interest were cholesterol test, blood pressure test, flu shot, endoscopy, blood stool test, clinical breast exam, mammography and prostate exam. We estimated propensity score weighted difference-in-difference (DID) models to test for differences in preventive services utilization based on Medicare insurance status. Nationwide, among beneficiaries with traditional Medicare only, who stood to gain the most from eliminating cost-sharing for preventive services, the percentage of women receiving clinical breast exams rose post-reform (Delta = 8.1%; p 0.05). Based on this analysis of MEPS data spanning 2006-2016, the ACA's enhancement of Medicare coverage had only modest effects on the percentage of beneficiaries receiving a range of preventive services. Medicare beneficiaries should be better informed of the availability of these services and encouraged by their physicians to avail the no cost-sharing incentive of these reforms.
机译：自2011年以来，《平价医疗法案》（ACA）要求为医疗保险中的个人提供某些推荐的临床预防服务，而不需要分担费用。我们使用医疗支出小组调查（MEPS）的数据，再次访问了ACA对医疗保险下预防服务利用的影响，并检查了ACA对医疗保险受益人预防服务利用的长期影响。我们分析了2006-2010年和2012-2016年医疗支出小组调查中关于非制度化医疗保险受益人（n=27124）的全国代表性数据。感兴趣的预防服务包括胆固醇测试、血压测试、流感疫苗、内窥镜检查、血便测试、临床乳房检查、乳房X光检查和前列腺检查。我们估计了倾向评分加权差异（DID）模型，以测试基于医疗保险状况的预防服务利用差异。在全国范围内，仅享受传统医疗保险的受益人中，由于取消了预防服务的成本分担，受益最多的是接受临床乳房检查的女性比例在改革后有所上升（Delta=8.1%；P0.05）。根据对MEPS 2006-2016年数据的分析，ACA对医疗保险覆盖范围的提高对接受一系列预防服务的受益人的百分比影响不大。医疗保险受益人应该更好地了解这些服务的可用性，并受到医生的鼓励，利用这些改革的无成本分担激励。

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