Robin Zhao, Linh He, Sara W Albert, Alexandra Li, Anaïs Rameau
{"title":"美国的吞咽困难护理：检查平价医疗法案对获得护理的影响。","authors":"Robin Zhao, Linh He, Sara W Albert, Alexandra Li, Anaïs Rameau","doi":"10.1002/ohn.1239","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>To report the odds of dysphagia treatment among adults with self-reported dysphagia before and after the implementation of the Affordable Care Act (ACA).</p><p><strong>Study design: </strong>Cross-sectional analysis.</p><p><strong>Setting: </strong>National Health Interview Survey (NHIS).</p><p><strong>Methods: </strong>Multivariate logistic regression.</p><p><strong>Results: </strong>This study included 490 million individuals from the 2012 and 2022 NHIS in weighted responses. Among 235 million individuals in 2012, 9.4 million (4.0%) reported dysphagia (median age, 56.0 years; interquartile range [IQR], 40.0-68.0 years; 60% female). Among 255 million adults in 2022, 15 million (5.9%) reported dysphagia (median age, 58.0 years; IQR, 40.0-71.0 years; 57% female). After adjusting for sociodemographic factors, adults in 2022 were significantly more likely than those in 2012 to report dysphagia (adjusted odds ratio [aOR], 1.64; CI, 1.43-1.87). However, there was no significant difference in the odds of reporting dysphagia treatment between 2012 and 2022. Subgroup analyses by age, race and ethnicity, and insurance type also revealed no significant differences when comparing the 2012 and 2022 cohorts. When examining general access to care, adults reporting dysphagia in 2022 were significantly less likely to delay medical care due to the cost compared to adults reporting dysphagia in 2012 (aOR, 0.52; 95% CI, 0.43-0.62).</p><p><strong>Conclusion: </strong>Although more adults reported dysphagia in 2022 than in 2012, our results show no significant improvement in access to dysphagia treatment. This suggests that, although the ACA reduced cost-related barriers, it has not adequately addressed access to dysphagia care.</p><p><strong>Level of evidence: </strong>IV.</p>","PeriodicalId":19707,"journal":{"name":"Otolaryngology- Head and Neck Surgery","volume":" ","pages":"162-170"},"PeriodicalIF":2.6000,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Dysphagia Care in the United States: Examining the Impact of the Affordable Care Act on Access to Care.\",\"authors\":\"Robin Zhao, Linh He, Sara W Albert, Alexandra Li, Anaïs Rameau\",\"doi\":\"10.1002/ohn.1239\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>To report the odds of dysphagia treatment among adults with self-reported dysphagia before and after the implementation of the Affordable Care Act (ACA).</p><p><strong>Study design: </strong>Cross-sectional analysis.</p><p><strong>Setting: </strong>National Health Interview Survey (NHIS).</p><p><strong>Methods: </strong>Multivariate logistic regression.</p><p><strong>Results: </strong>This study included 490 million individuals from the 2012 and 2022 NHIS in weighted responses. Among 235 million individuals in 2012, 9.4 million (4.0%) reported dysphagia (median age, 56.0 years; interquartile range [IQR], 40.0-68.0 years; 60% female). Among 255 million adults in 2022, 15 million (5.9%) reported dysphagia (median age, 58.0 years; IQR, 40.0-71.0 years; 57% female). After adjusting for sociodemographic factors, adults in 2022 were significantly more likely than those in 2012 to report dysphagia (adjusted odds ratio [aOR], 1.64; CI, 1.43-1.87). However, there was no significant difference in the odds of reporting dysphagia treatment between 2012 and 2022. Subgroup analyses by age, race and ethnicity, and insurance type also revealed no significant differences when comparing the 2012 and 2022 cohorts. When examining general access to care, adults reporting dysphagia in 2022 were significantly less likely to delay medical care due to the cost compared to adults reporting dysphagia in 2012 (aOR, 0.52; 95% CI, 0.43-0.62).</p><p><strong>Conclusion: </strong>Although more adults reported dysphagia in 2022 than in 2012, our results show no significant improvement in access to dysphagia treatment. This suggests that, although the ACA reduced cost-related barriers, it has not adequately addressed access to dysphagia care.</p><p><strong>Level of evidence: </strong>IV.</p>\",\"PeriodicalId\":19707,\"journal\":{\"name\":\"Otolaryngology- Head and Neck Surgery\",\"volume\":\" \",\"pages\":\"162-170\"},\"PeriodicalIF\":2.6000,\"publicationDate\":\"2025-07-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Otolaryngology- Head and Neck Surgery\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1002/ohn.1239\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/4/1 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q1\",\"JCRName\":\"OTORHINOLARYNGOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Otolaryngology- Head and Neck Surgery","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1002/ohn.1239","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/4/1 0:00:00","PubModel":"Epub","JCR":"Q1","JCRName":"OTORHINOLARYNGOLOGY","Score":null,"Total":0}
Dysphagia Care in the United States: Examining the Impact of the Affordable Care Act on Access to Care.
Objective: To report the odds of dysphagia treatment among adults with self-reported dysphagia before and after the implementation of the Affordable Care Act (ACA).
Study design: Cross-sectional analysis.
Setting: National Health Interview Survey (NHIS).
Methods: Multivariate logistic regression.
Results: This study included 490 million individuals from the 2012 and 2022 NHIS in weighted responses. Among 235 million individuals in 2012, 9.4 million (4.0%) reported dysphagia (median age, 56.0 years; interquartile range [IQR], 40.0-68.0 years; 60% female). Among 255 million adults in 2022, 15 million (5.9%) reported dysphagia (median age, 58.0 years; IQR, 40.0-71.0 years; 57% female). After adjusting for sociodemographic factors, adults in 2022 were significantly more likely than those in 2012 to report dysphagia (adjusted odds ratio [aOR], 1.64; CI, 1.43-1.87). However, there was no significant difference in the odds of reporting dysphagia treatment between 2012 and 2022. Subgroup analyses by age, race and ethnicity, and insurance type also revealed no significant differences when comparing the 2012 and 2022 cohorts. When examining general access to care, adults reporting dysphagia in 2022 were significantly less likely to delay medical care due to the cost compared to adults reporting dysphagia in 2012 (aOR, 0.52; 95% CI, 0.43-0.62).
Conclusion: Although more adults reported dysphagia in 2022 than in 2012, our results show no significant improvement in access to dysphagia treatment. This suggests that, although the ACA reduced cost-related barriers, it has not adequately addressed access to dysphagia care.
期刊介绍：
Otolaryngology–Head and Neck Surgery (OTO-HNS) is the official peer-reviewed publication of the American Academy of Otolaryngology–Head and Neck Surgery Foundation. The mission of Otolaryngology–Head and Neck Surgery is to publish contemporary, ethical, clinically relevant information in otolaryngology, head and neck surgery (ear, nose, throat, head, and neck disorders) that can be used by otolaryngologists, clinicians, scientists, and specialists to improve patient care and public health.
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