Stable health insurance is often associated with better chronic disease care and outcomes. Racial/ethnic health disparities in outcomes are prevalent and may be associated with insurance instability, particularly in the context of health insurance reform. We examined whether insurance instability was associated with uncontrolled blood pressure (UBP) and whether this association varied by race/ethnicity. We used a retrospective longitudinal observational cohort study of patients diagnosed with hypertension who obtained care within two health systems in Massachusetts. We measured the UBP, insurance instability, and race of 43,785 adult primary care patients, age 21–64 with visits from 1/2005–12/2013. We found higher rates of UBP for blacks and Hispanics at each time point over the entire 9 years. Insurance instability was associated with greater rates of UBP. Always uninsured black patients fared worst, while white and Hispanic patients with consistent public insurance fared best. Stable insurance of any type was associated with better hypertension control than no or unstable insurance.

中文翻译：

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保险不稳定与高血压结果相关吗？这是否因种族/民族而异？


稳定的健康保险通常与更好的慢性病护理和结果相关。种族/民族健康结果差异普遍存在，可能与保险不稳定有关，特别是在医疗保险改革的背景下。我们研究了保险不稳定是否与血压失控（UBP）相关，以及这种关联是否因种族/民族而异。我们对在马萨诸塞州两个卫生系统中接受护理的被诊断患有高血压的患者进行了一项回顾性纵向观察队列研究。我们对 2005 年 1 月 1 日至 2013 年 12 月就诊的 43,785 名成年初级保健患者（年龄在 21 至 64 岁之间）的 UBP、保险不稳定度和种族进行了测量。我们发现，在整个 9 年里，黑人和西班牙裔在每个时间点的 UBP 发病率都较高。保险不稳定与较高的 UBP 率相关。始终没有保险的黑人患者表现最差，而拥有持续公共保险的白人和西班牙裔患者表现最好。任何类型的稳定保险都比没有保险或不稳定保险能更好地控制高血压。