哮喘联盟

   摘要
   背景：由于美国健康保险市场的复杂性以及由这些复杂性引发的混乱，患者对医疗保险管理慢性疾病的价值的理解是很重要的。
   目的：研究旨在分析公共和个人医疗保险在经济负担观念方面的不同，经济负担由管理哮喘、预后和可以解释这些观念的因素带来。
   方法：研究对一项随机临床试验的基线数据进行二次分析，此项临床试验收集219例非洲裔妇女的电话访问，她们的电话访问旨在为哮喘寻求帮助并报告对于哮喘管理的经济负担观念。研究使用多组模型和多变量回归分析的路径分析方法检测相关性。
   结果：包括公共（P <0.001）和个人（P <0.01）在内，已婚和更高的文化程度与经济负担的更多认知间接相关，这些经济负担可以通过不同的解释途径进行解释。
   当调整多个并发症、哮喘控制、收入和自付费用后，与那些有公共保险的人群相比，有个人保险的人群将使用更少的住院（P <0.05）和急诊科（P <0.001）服务。当同时调整医疗保险后，更大的经济负担与更多的紧急办公室拜访次数（P <0.001）和更低的生活质量（P <0.001）相关。
   结论：无论有无医疗保险，认为哮喘是一种经济负担的非洲裔妇女报告更多的紧急医疗访问和更低的生活质量。尽管拥有并能够获得经济来源和医疗保险，负担可能依然存在。进一步的政策努力显示，应特别注意覆盖的类型。
 

（苏楠 审校）
AnnAllergyAsthmaImmunol.2014Aug1.pii:S1081-1206(14)00461-X.doi:10.1016/j.anai.2014.07.004. [Epub ahead of print]

 

Patient perceptions of asthma-related financial burden: public vs private health insurance in the United States.
 

Patel MR1, Caldwell CH2, Song PX3, Wheeler JR4.
 

ABSTRACT
BACKGROUND: Given the complexity of the health insurance market in the United States and the confusion that often stems from these complexities, patient perception about the value of health insurance in managing chronic disease is important to understand.
OBJECTIVE: To examine differences between public and private health insurance in perceptions of financial burden with managing asthma, outcomes, and factors that explain these perceptions.
METHODS: Secondary analysis was performed using baseline data from a randomized clinical trial that were collected through telephone interviews with 219 African American women seeking services for asthma and reporting perceptions of financial burden with asthma management. Path analysis with multigroup models and multiple variable regression analyses were used to examine associations.
RESULTS: For public (P < .001) and private (P < .01) coverage, being married and more educated were indirectly associated with greater perceptions of financial burden through different explanatory pathways. When adjusted for multiple morbidities, asthma control, income, and out-of-pocket expenses, those with private insurance used fewer inpatient (P < .05) and emergency department (P < .001) services compared with those with public insurance. When also adjusted for health insurance, greater financial burden was associated with more urgent office visits (P < .001) and lower quality of life (P < .001).
CONCLUSION: African American women who perceive asthma as a financial burden regardless of health insurance report more urgent health care visits and lower quality of life. Burden may be present despite having and being able to generate economic resources and health insurance. Further policy efforts are indicated and special attention should focus on type of coverage.
 

AnnAllergyAsthmaImmunol.2014Aug1.pii:S1081-1206(14)00461-X.doi:10.1016/j.anai.2014.07.004. [Epub ahead of print]