Beyond Coverage and Controversy: The ACA’s Distinctly American Approach to Healthcare Coverage and Reform

2021 ◽  
pp. 23-30
Author(s):  
Shawn Maree Bishop
Keyword(s):  
Healthcare Coverage

scholarly journals Self-Rated Health Status Based on the Type of Health Insurance: A Socioeconomic Perspective

2021 ◽  
Vol 58 ◽  
pp. 004695802110281
Author(s):  
Minsung Sohn ◽  
Minsoo Jung ◽  
Mankyu Choi
Keyword(s):  
Socioeconomic Status ◽  
Health Insurance ◽  
Health Status ◽  
Regression Models ◽  
Private Health Insurance ◽  
Public And Private ◽  
Logistic Regression Models ◽  
Self Rated Health ◽  
Interaction Terms ◽  
Healthcare Coverage

To investigate the effects of public and private health insurance on self-rated health (SRH) status within the National Health Insurance (NHI) system based on socioeconomic status in South Korea. The data were obtained from 10 867 respondents of the Korea Health Panel (2008-2011). We used hierarchical panel logistic regression models to assess the SRH status. We also added the interaction terms of socioeconomic status and type of health insurance as moderators. Medical aid (MA) recipients were 2.10 times more likely to have a low SRH status than those who were covered only by the NHI, even though the healthcare utilization was higher. When the interaction terms were included, those not covered by the NHI and had completed elementary school or less were 16.59 times more likely to have a low SRH status than those covered by the NHI and had earned a college degree or higher. Expanding healthcare coverage to reduce the burden of non-payment and unmet use to improve the health status of MA beneficiaries should be considered. Particularly, the vulnerability of less-educated groups should be focused on.

scholarly journals Why does healthcare utilisation differ between socioeconomic groups in OECD countries with universal healthcare coverage? A protocol for a systematic review

BMJ Open ◽  
2021 ◽  
Vol 11 (11) ◽  
pp. e054806
Author(s):  
Iris Meulman ◽  
Ellen Uiters ◽  
Johan Polder ◽  
Niek Stadhouders
Keyword(s):  
Systematic Review ◽  
Healthcare Access ◽  
Healthcare Utilisation ◽  
Oecd Countries ◽  
Primary Data ◽  
Scientific Article ◽  
Socioeconomic Groups ◽  
Universal Healthcare ◽  
Healthcare Coverage ◽  
Universal Healthcare Coverage

IntroductionEven in advanced economies with universal healthcare coverage (UHC), a social gradient in healthcare utilisation has been reported. Many individual, community and healthcare system factors have been considered that may be associated with the variation in healthcare utilisation between socioeconomic groups. Nevertheless, relatively little is known about the complex interaction and relative contribution of these factors to socioeconomic differences in healthcare utilisation. In order to improve understanding of why utilisation patterns differ by socioeconomic status (SES), the proposed systematic review will explore the main mechanisms that have been examined in quantitative research.Methods and analysisThe systematic review will follow the Preferred Reporting Items for Systematic Review and Meta-Analyses guidelines and will be conducted in Embase, PubMed, Scopus, Web of Science, Econlit and PsycInfo. Articles examining factors associated with the differences in primary and specialised healthcare utilisation between socioeconomic groups in Organisation for Economic Co-operation and Development (OECD) countries with UHC will be included. Further restrictions concern specifications of outcome measures, factors of interest, study design, population, language and type of publication. Data will be numerically summarised, narratively synthesised and thematically discussed. The factors will be categorised according to existing frameworks for barriers to healthcare access.Ethics and disseminationNo primary data will be collected. No ethics approval is required. We intend to publish a scientific article in an international peer-reviewed journal.

scholarly journals An innovative service but will it work in practice? Commentary on … Fair Horizons

2012 ◽  
Vol 36 (1) ◽  
pp. 30-31 ◽  
Author(s):  
Stephen Patrick Tyrer
Keyword(s):  
National Health Service ◽  
Health Service ◽  
National Health ◽  
Mental Healthcare ◽  
New Development ◽  
Healthcare Coverage ◽  
System Success ◽  
New System

SummaryThis commentary discusses the proposed service, Fair Horizons, a new development designed to ensure comprehensive mental healthcare coverage. Although the aims of the new service are laudable and derive from recent seminal papers on changes in the National Health Service, the proposed initiatives are so far untested and there is uncertainty about how far costs will be reduced under this new system. Success is more likely to result if clinicians are committed to the new service and work harder.

Health inequalities in hospitalisation and mortality in patients diagnosed with heart failure in a universal healthcare coverage system

2018 ◽  
Vol 72 (9) ◽  
pp. 845-851 ◽  
Author(s):  
Raquel Garcia ◽  
Rosa Abellana ◽  
Jordi Real ◽  
José-Luis del Val ◽  
Jose Maria Verdú-Rotellar ◽  
...  
Keyword(s):  
Heart Failure ◽  
Total Mortality ◽  
Community Dwelling ◽  
Socioeconomic Groups ◽  
Universal Healthcare ◽  
Cox Proportional Hazard ◽  
Increased Risk ◽  
Healthcare Coverage ◽  
Cox Proportional Hazard Models ◽  
Universal Healthcare Coverage

BackgroundInformation regarding the effect of social determinants of health on heart failure (HF) community-dwelling patients is scarce. We aimed to analyse the presence of socioeconomic inequalities, and their impact on hospitalisations and mortality, in patients with HF attended in a universal healthcare coverage system.MethodsA retrospective cohort study carried out in patients with HF aged >40 and attended at the 53 primary healthcare centres of the Institut Català de la Salut in Barcelona (Spain). Socioeconomic status (SES) was determined by an aggregated deprivation index (MEDEA). Cox proportional hazard models and competing-risks regression based on Fine and Gray’s proportional subhazards were performed to analyse hospitalisations due to of HF and total mortality that occurred between 1 January 2009 and 31 December 2012.ResultsMean age was 78.1 years (SD 10.2) and 56% were women. Among the 8235 patients included, 19.4% died during the 4 years of follow-up and 27.1% were hospitalised due to HF. A gradient in the risk of hospitalisation was observed according to SES with the highest risk in the lowest socioeconomic group (sHR 1.46, 95% CI 1.27 to 1.68). Nevertheless, overall mortality did not differ among the socioeconomic groups.ConclusionsIn spite of finding a gradient that linked socioeconomic deprivation to an increased risk of hospitalisation, there were no differences in mortality regarding SES in a universal healthcare coverage system.

scholarly journals Evidences supporting the inclusion of immigrants in the universal healthcare coverage

2020 ◽  
Vol 30 (4) ◽  
pp. 785-787
Author(s):  
Albert Prats-Uribe ◽  
Sílvia Brugueras ◽  
Dolors Comet ◽  
Dolores Álamo-Junquera ◽  
LLuïsa Ortega Gutiérrez ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Heart Failure ◽  
Infectious Diseases ◽  
Chronic Obstructive ◽  
Matched Sample ◽  
Obstructive Pulmonary Disease ◽  
Universal Healthcare ◽  
Primary Health ◽  
Healthcare Coverage ◽  
Universal Healthcare Coverage

Abstract In 2012, the Spanish government enforced a healthcare exclusion policy against undocumented immigrants. The newly elected government has recently derogated this policy. To analyze how this decree could have affected population health, we looked at primary health patients who would have been excluded and compared with a matched sample of non-excluded patients. Potentially excluded patients had decreased odds of: depression, chronic obstructive pulmonary disease, dyslipidaemia, heart failure and hypertension while diabetes mellitus rates were similar to non-excluded. Infectious diseases were more frequent in potentially excluded population (HIV, tuberculosis and syphilis). The exclusion of patients impedes the control of infectious diseases at a community level.

Sign in / Sign up

Export Citation Format

Share Document