保険のカバーを質の高い医療に変換する:電圧は潜在的から提供された質の高い医療に低下する
1Agency for Healthcare Research and Quality, Department of Health and Human Services, 2101 E Jefferson St, Rockville, MD 20852, USA. jeisenbe@ahrq.gov
JAMA
|October 24, 2000
まとめ
高品質の米国の医療を保証するには,保険の範囲を超えた脆弱性に対処する必要があります. 医療へのアクセス,医療提供者の選択,一貫したプライマリ・サービスとリファール・サービスの受け取りにおいて,ギャップが存在します.
科学分野:
- 医療サービス 研究 医療サービス
- 公共衛生政策 公共衛生政策
- 医療の格差 医療の格差
背景:
- 米国保健医療制度は,人口,地域,機関間の医療の質において大きな格差に直面しています.
- 医療保険のイニシアチブは,医療へのアクセスを改善することを目的としていますが,質の高い医療成果を保証するものではありません.
- システムの弱点を理解することは,医療の提供を改善するために不可欠です.
研究 の 目的:
- 高品質の医療の達成が損なわれる米国保健医療システム内の脆弱性の重要な点を特定する.
- 保険の適用から医療サービスの提供までのアクセスのチェーンを分析する.
主な方法:
- ヘルスケア・デリバリー・パスウェイの概念分析
- システムにおける7つの主要な"電圧低下"または故障点を特定する.
- 保険へのアクセス,入学,サービス,および一貫したケアに影響を与える要因のレビュー.
主要な成果:
- 特定された脆弱性には,保険へのアクセス,プランへの登録,保険対象のサービスとプロバイダへのアクセス,プランとプロバイダの選択,一貫したプライマリケアへのアクセス,紹介サービスへのアクセス,および医療提供の質が含まれます.
- 特定された"電圧の低下"は,高品質のケアを達成するための潜在的な損失ポイントを表しています.
- 保険のカバーだけでは,質の高いケアを保証するには不十分です.
結論:
- 系統的な"電圧低下"に対処することは,すべてのアメリカ人に高品質の医療を提供するために不可欠です.
- 政策と実践は,カバーからサービス提供まで,複数の段階でのアクセスを改善することに焦点を当てなければなりません.
- 医療の格差を克服し,全体的な医療の質を向上させるために,包括的なアプローチが必要です.
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