High-deductible health plans (HDHPs) are becoming more popular owing to their potential to curb rising health care costs. Relative to traditional health insurance plans, HDHPs involve higher out-of-pocket costs for consumers, which have been associated with lower utilization of health services. We focus specifically on the impact that HDHPs have on the use of preventive services. We critique the current evidence by discussing the benefits and drawbacks of the research designs used to examine this relationship. We also summarize the findings from the most methodologically sophisticated studies. We conclude that the balance of the evidence shows that HDHPs are reducing the use of some preventive service, especially screenings. However, it is not clear if HDHPs affect all preventive services. Additional research is needed to determine why variability in conclusions exists among studies. We describe an agenda for future research that can further inform public health decision makers on the impact of HDHPs on prevention.

中文翻译：

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高扣除额健康计划和预防。

高扣除额医疗计划（HDHPs）由于其潜在的遏制不断上升的医疗保健成本而变得越来越受欢迎。相对于传统的健康保险计划，HDHP为消费者带来了更高的自付费用，这与医疗服务的利用率较低有关。我们特别关注HDHP对预防性服务使用的影响。通过讨论用于检验这种关系的研究设计的利弊，我们对当前证据进行了评论。我们还将总结最复杂的方法学研究结果。我们得出结论，证据的平衡表明，HDHP正在减少某些预防服务的使用，尤其是筛查。但是，尚不清楚HDHP是否会影响所有预防服务。需要进行额外的研究来确定为什么研究之间的结论存在变异性。我们描述了一个未来研究的议程，该议程可以进一步向公共卫生决策者提供有关HDHP对预防的影响的信息。