Lindsey Jeanne Leininger, Courtney Bragg, Allister Chang, Andrea Palm
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引用次数: 0
Abstract
Objectives: To estimate the prevalence of unmet health care and health-related social needs (HRSNs) among laundromat users and examine differences by health insurance coverage.
Study design: Cross-sectional observational study.
Methods: We collected a survey from participants in a pilot intervention conducted in 14 Pennsylvania laundromats between September and December 2023. The measures included health insurance coverage, unmet health care needs, and unmet HRSNs. Descriptive analyses and linear probability regression models with laundromat fixed effects were used to estimate the overall prevalence of unmet needs and explore subgroup differences.
Results: Among the 1995 sample members, approximately half (52.9%) had Medicaid coverage, 21.7% had private coverage, 14.5% were uninsured, 5.4% had Medicare, and 5.5% were dually enrolled in Medicare and Medicaid. The prevalence of having any unmet HRSN was higher than having any unmet health care need (54.3% vs 12.3%). Across unmet need measures, Medicaid sample members had 1.5 to 5 times higher levels relative to the privately insured. Differences by insurance coverage remained in fixed-effects analyses that limited comparisons to laundromat users at the same location.
Conclusions: Laundromat-based outreach is likely most promising for Medicaid-serving stakeholders because Medicaid enrollees are disproportionately represented among laundromat users and have disproportionately high levels of unmet needs.
目的:估计未满足的卫生保健和健康相关社会需求(HRSNs)在自助洗衣店用户中的流行程度,并检查健康保险覆盖率的差异。研究设计:横断面观察性研究。方法:我们收集了2023年9月至12月在宾夕法尼亚州14家自助洗衣店进行的试点干预参与者的调查。这些措施包括健康保险覆盖范围、未满足的保健需求和未满足的hrsn。采用描述性分析和具有自助洗衣店固定效应的线性概率回归模型来估计未满足需求的总体发生率,并探讨亚组差异。结果:在1995年的样本成员中,大约一半(52.9%)的人有医疗补助保险,21.7%的人有私人保险,14.5%的人没有保险,5.4%的人有医疗保险,5.5%的人同时参加医疗保险和医疗补助。未满足HRSN的患病率高于未满足医疗保健需求的患病率(54.3% vs 12.3%)。在未满足需求的措施中,医疗补助样本成员的水平相对于私人保险高出1.5至5倍。保险覆盖范围的差异仍然存在于固定效应分析中,这种分析限制了对同一地点自助洗衣店用户的比较。结论:以自助洗衣店为基础的推广对医疗补助服务的利益相关者来说可能是最有希望的,因为医疗补助计划的参保者在自助洗衣店用户中所占的比例不成比例,并且有不成比例的高水平的未满足需求。
期刊介绍:
The American Journal of Managed Care is an independent, peer-reviewed publication dedicated to disseminating clinical information to managed care physicians, clinical decision makers, and other healthcare professionals. Its aim is to stimulate scientific communication in the ever-evolving field of managed care. The American Journal of Managed Care addresses a broad range of issues relevant to clinical decision making in a cost-constrained environment and examines the impact of clinical, management, and policy interventions and programs on healthcare and economic outcomes.