Disability-Related Disparities in Access to Health Care Before (2008–2010) and After (2015–2017) the Affordable Care Act.

Objectives. To explore the effect of the Affordable Care Act (ACA) on disparities in access to health care based on disability status, as well as age, income, race, and ethnicity. Methods. In this study, I used logistic regression to analyze nationally representative data from 128 000 respondents to...

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Publicado en:American Journal of Public Health Vol. 109; no. 7; pp. 1015 - 1022
Autor principal: Kaye, H. Stephen
Formato: Artículo
Publicado: American Public Health Association Jul2019
Materias:
Acceso en línea:Ver este registro en EBSCOhost
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      pub: American Public Health Association
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        10.2105/AJPH.2019.305056
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        atl: Disability-Related Disparities in Access to Health Care Before (2008–2010) and After (2015–2017) the Affordable Care Act.
      aug:
        au: Kaye, H. Stephen
        affil: H. Stephen Kaye is with the Institute for Health and Aging, University of California San Francisco.
      su:
        United States
        Health services accessibility
        Health equity
        Disabilities
        Public health
        Age distribution
        Ethnic groups
        Health status indicators
        Income
        Medical care costs
        Mental illness
        People with disabilities
        Race
        Medical care for people with disabilities
        Patient Protection & Affordable Care Act
        Americans with Disabilities Act of 1990
        Medicaid eligibility
        Surveys
        Logistic regression analysis
      sug:
        subj:
          Health services accessibility
          Health equity
          Disabilities
          Public health
          Age distribution
          Ethnic groups
          Health status indicators
          Income
          Medical care costs
          Mental illness
          People with disabilities
          Race
          United States
          Health and Welfare Funds
          Medical care for people with disabilities
          Patient Protection & Affordable Care Act
          Americans with Disabilities Act of 1990
          Medicaid eligibility
          Surveys
          Logistic regression analysis
      ab: Objectives. To explore the effect of the Affordable Care Act (ACA) on disparities in access to health care based on disability status, as well as age, income, race, and ethnicity. Methods. In this study, I used logistic regression to analyze nationally representative data from 128 000 respondents to the US National Health Interview Survey from 2008 to 2010 and 2015 to 2017. Outcome variables were uninsurance over the previous 12 months, delayed or forgone health care for reasons of cost, and having a regular provider at a doctor's office or health clinic. Results. Over the period when the ACA was implemented, large existing disparities in access to health care were reduced for people with certain types of disabilities, young adults aged 19 to 25 years, and low-income families. Conclusions. The ACA improved overall access to health care and reduced some disparities, but substantial disparities persist. Disability status remains associated with much greater risk of delayed or forgone care, and mental health disability is associated with greater likelihood of uninsurance. Public Health Implications. The ACA partially achieved its goals and must not be weakened or rolled back. Further policy efforts are needed to address the remaining disparities.
      pubtype: Academic Journal
      doctype: Article
      src: R
    language: English
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