Background In recent years, policymakers have sought to reduce health disparities between the insured and uninsured through a federal health insurance expansion policy; however, disparities continue to persist among the insured population. One potential explanation is that the use of healthcare services varies by the type of health insurance coverage due to differences in the design of coverage. The aim of this study is to examine whether health insurance coverage type is associated with the structure and use of healthcare services. Methods The nationally representative Medical Expenditure Panel Survey and multinomial logistic regression are used to estimate the effects of different types of health coverage on the combinations of routine and emergency care sought and received. Results The multinomial logistic regression analysis for the overall sample revealed privately insured respondents reported higher use of routine care only (24.33%; p < 0.001) and lower use of emergency room care only (− 2.13%; p < 0.01) than the uninsured. The publicly insured reported similar trends for use of routine care only (17.93%; p < 0.001) as the privately insured, as compared to the uninsured. Both the privately and publicly insured reported higher use of a mixture of care; however, publicly insured were more likely to use a mixture of care (8.57%, p < 0.001). Conclusion The results show that health insurance is associated with higher use of the physician services, but does not promote the use of cost-effective schedules of care among the publicly insured.

中文翻译：

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健康保险对患者对医师服务的需求的影响。

背景技术近年来，政策制定者试图通过联邦健康保险扩展政策来缩小被保险人与未保险人之间的健康差距；但是，被保险人口之间的差距仍然存在。一种可能的解释是，由于医疗保险设计的不同，医疗服务的使用因医疗保险的类型而异。这项研究的目的是检查健康保险的承保类型是否与医疗服务的结构和使用有关。方法：使用具有全国代表性的医疗支出面板调查和多项逻辑回归来估计不同类型的健康保险对寻求和接受的常规和急诊护理组合的影响。结果总体样本的多项逻辑回归分析显示，与未投保的人相比，私人参保的受访者仅使用常规护理的比例较高（24.33％； p <0.001），而对急诊室的护理的比例较低（− 2.13％; p <0.01）。与未投保人相比，公共投保人报告仅使用常规护理的趋势与私人投保人相似（17.93％； p <0.001）。私人和公共保险公司都报告说更多地使用了混合护理。但是，公共保险公司更可能采用混合护理（8.57％，p <0.001）。结论结果表明，健康保险与医生服务的更高使用率相关，但并不能促进公共保险公司使用具有成本效益的护理计划。