■通过将医疗保险扩展到美国数百万人,患者保护和平价医疗法案(ACA)可能具有重要的健康,经济,以及对刑事法律参与人群的社会福利影响-发病率和死亡率过高的人群。
■为评估ACA的任何规定与5种结果的关联的研究,包括保险覆盖率,获得护理,健康结果,护理费用,以及涉及刑事法律的人的社会福利结果。
■文献检索包括PubMed的结果,CINAHL完成,APAPsycinfo,Embase,社会科学数据库,和WebofScience,并进行了包括从2014年1月1日至2023年12月31日的文章。只包括原始的实证研究,但对研究设计没有限制。
■在最初确定为潜在纳入的3538项研究中,最终样本包括19项研究.这19项研究在刑事法律参与的定义和分析单位方面存在很大差异。这些研究在研究设计方面也有所不同,但纳入的10项研究采用了差异差异法.关于结果,在19项研究中确定了100项独特的结果,在文献检索之前确定的所有5个结局类别中至少有一个。健康保险覆盖范围和获得护理是最常见的研究结果。其他3个结果类别的结果是混合的,可能是由于种群定义的异质性,干预措施,以及将监禁数据与健康相关数据联系起来的个人级别数据集的可用性受到限制。
■在此范围审查中,在涉及刑事法律的人群中,ACA与保险覆盖率的增加和累犯率的降低有关.需要进行未来的研究和数据收集,以更全面地了解与ACA和其他健康保险政策相关的刑事法律参与人群的健康和非健康结果,以及这些关系的潜在机制。
UNASSIGNED: By expanding health insurance to millions of people in the US, the Patient Protection and Affordable Care Act (ACA) may have important health, economic, and social welfare implications for people with criminal legal involvement-a population with disproportionately high morbidity and mortality rates.
UNASSIGNED: To scope the literature for studies assessing the association of any provision of the ACA with 5 types of outcomes, including insurance coverage rates, access to care, health outcomes, costs of care, and social welfare outcomes among people with criminal legal involvement.
UNASSIGNED: The literature search included results from PubMed, CINAHL Complete, APA Psycinfo, Embase, Social Science Database, and Web of Science and was conducted to include articles from January 1, 2014, through December 31, 2023. Only original empirical studies were included, but there were no restrictions on study design.
UNASSIGNED: Of the 3538 studies initially identified for potential inclusion, the final sample included 19 studies. These 19 studies differed substantially in their definition of criminal legal involvement and units of analysis. The studies also varied with respect to study design, but difference-in-differences methods were used in 10 of the included studies. With respect to outcomes, 100 unique outcomes were identified across the 19 studies, with at least 1 in all 5 outcome categories determined prior to the literature search. Health insurance coverage and access to care were the most frequently studied outcomes. Results for the other 3 outcome categories were mixed, potentially due to heterogeneous definitions of populations, interventions, and outcomes and to limitations in the availability of individual-level datasets that link incarceration data with health-related data.
UNASSIGNED: In this scoping
review, the ACA was associated with an increase in insurance coverage and a decrease in recidivism rates among people with criminal legal involvement. Future research and data collection are needed to understand more fully health and nonhealth outcomes among people with criminal legal involvement related to the ACA and other health insurance policies-as well as the mechanisms underlying these relationships.