美国的医疗改革致力于提高医疗价值，但仍存在关于基于价值的医疗服务不公平的担忧。我们研究了受教育水平对高价值和低价值医疗服务接受情况的差异。我们采用重复横截面研究设计，使用2010年至2019年的医疗费用调查数据。我们的结果包括3个类别的8项高价值服务和3个类别的9项低价值服务。我们的主要自变量是教育水平：(i)无学位，(ii)高中文凭，(iii)大学毕业。我们进行了线性概率模型，调整了个体水平特征，并估计了每个教育群体的调整后结果值。在几乎所有服务中，受教育程度较高的成年人使用高价值服务的比例大于受教育程度较低的成年人。与没有学位的人相比，拥有大学学位的人在除了HbA1c检测之外的所有高价值服务中都更有可能接受，从血压测量（4.5个百分点[95% CI：3.9-5.1]）到结直肠癌筛查（15.6个百分点[95% CI: 13.9-17.3]）。然而，在低价值医疗服务的使用上，没有明显一致的教育水平模式。我们的研究结果表明，与受教育程度较低的成年人相比，受教育程度较高的成年人更有可能接受高价值的癌症筛查、高价值的诊断和预防性检测以及高价值的糖尿病护理。这些结果突显了在美国实施针对教育不平等问题的定制政策在提供高价值服务方面的重要性。©作者（2023）。由牛津大学出版社出版。版权所有。如需权限，请发送电子邮件至：journals.permissions@oup.com。

Healthcare reform in the United States has focused on improving the value of health care, but there are some concerns about the inequitable delivery of value-based care.We examine whether the receipt of high- and low-value care differs by education levels.We employed a repeated cross-sectional study design using data from the 2010-2019 Medical Expenditure Panel Survey. Our outcomes included 8 high-value services across 3 categories and 9 low-value services across 3 categories. Our primary independent variable was education level: (i) no degree, (ii) high school diploma, and (iii) college graduate. We conducted a linear probability model while adjusting for individual-level characteristics and estimated the adjusted values of the outcomes for each education group.In almost all services, the use of high-value care was greater among more educated adults than less educated adults. Compared to those with no degree, those with a college degree were significantly more likely to receive all high-value services except for HbA1c measurement, ranging from blood pressure measurement (4.5 percentage points [95% CI: 3.9-5.1]) to colorectal cancer screening (15.6 percentage points [95% CI: 13.9-17.3]). However, there were no consistent patterns of the use of low-value care by education levels.Our findings suggest that more educated adults were more likely to receive high-value cancer screening, high-value diagnostic and preventive testing, and high-value diabetes care than less educated adults. These findings highlight the importance of implementing tailored policies to address education-based inequities in the delivery of high-value services in the United States.© The Author(s) 2023. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.