2010-2017年aca后18-64岁成年人的常见护理来源

IF 5.1 2区医学 Q1 MEDICINE, GENERAL & INTERNAL

Annals of Family Medicine Pub Date : 2025-09-22 DOI:10.1370/afm.240620

Sara Shahbazi, John D Goodson

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引用次数: 0

摘要

本研究使用2010-2017年医疗支出小组调查数据，评估了《平价医疗法案》实施后，不同收入群体和城乡环境中自我报告的通常护理来源（USC）的变化。多变量回归估计了USC调整后的百分比变化以及缺乏USC的原因。通常护理来源的患病率略有上升（67%至68%），低收入成年人的显著增长（农村+4.96%，城市+2.45%），城市高收入成年人的小幅下降。与负担能力相关的障碍减少了，而可及性和个人偏好障碍增加了。研究结果表明，仅仅扩大保险范围可能无法确保持续的护理，特别是考虑到持续的非金融获取挑战。

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Usual Source of Care Among Adults Aged 18-64 Years Post-ACA, 2010-2017.

This study assessed changes in self-reported usual source of care (USC) across income groups and rural-urban settings after Affordable Care Act implementation, using 2010-2017 Medical Expenditure Panel Survey data. Multivariable regression estimated adjusted percentage changes in USC and reasons for lacking one. Usual source of care prevalence rose modestly (67% to 68%), with significant gains among low-income adults (+4.96% rural, +2.45% urban) and a small decline among urban high-income adults. Affordability-related barriers decreased, while accessibility and individual preference barriers increased. Findings suggest that insurance expansion alone may not ensure continuous care, especially given persistent non-financial access challenges.

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来源期刊

Annals of Family Medicine 医学-医学：内科

CiteScore

3.70

自引率

4.50%

发文量

142

审稿时长

6-12 weeks

期刊介绍： The Annals of Family Medicine is a peer-reviewed research journal to meet the needs of scientists, practitioners, policymakers, and the patients and communities they serve.