PDF(Pubmed)
Abstract：
Despite higher per-capita health care spending than any other country, the United States lags far behind in health outcomes. Additionally, there are significant health inequities by race, ethnicity, socioeconomic position, and rurality. One set of potential solutions to improve these outcomes and reduce inequities is through health policy. Policy focused on improving access to care through insurance coverage, such as the Affordable Care Act\'s Medicaid expansion, has led to better health and reduced mortality. Policy aimed at improving health care delivery, including value-based payment and alternative payment models, has improved quality of care but has had little impact on population health outcomes. Policies that influence broader issues of economic opportunity likely have a strong influence on health, but lack the evidence base of more targeted interventions. To advance health outcomes and equity, further policy change is crucial.
摘要：
尽管人均医疗支出高于其他任何国家，美国在健康结果方面远远落后。此外,种族之间存在严重的健康不平等，种族,社会经济地位,和乡村。改善这些结果和减少不平等的一套潜在解决方案是通过卫生政策。政策侧重于通过保险范围改善获得护理的机会，比如平价医疗法案的医疗补助扩张，导致更好的健康和降低死亡率。旨在改善医疗保健服务的政策，包括基于价值的支付和替代支付模式，改善了医疗质量，但对人群健康结果影响不大。影响更广泛的经济机会问题的政策可能对健康产生重大影响，但缺乏更有针对性的干预措施的证据基础。为了促进健康结果和公平，进一步的政策变化至关重要。
