ノースカロライナ州のメディケイドへの小児科医の参加に関連する要因
P A Margolis1, R L Cook, J A Earp
1Department of Pediatrics, School of Medicine, University of North Carolina, Chapel Hill 27599-7490.
JAMA
|April 8, 1992
まとめ
メディケイドへの小児科医の参加は,報酬だけでなく,コミュニティのリソースと実践規範の影響を受けます. 医療へのアクセスの改善には,知識のギャップとコミュニティのサポートに対処することが必要であり,メディケイドの支払いの増加だけでは影響が限られているからです.
科学分野:
- 医療サービス 研究 医療サービス
- 小児科は小児科です.
- 公共衛生政策 公共衛生政策
背景:
- 小児科医のメディケイド参加は,恵まれない子どものケアへのアクセスを確保するために不可欠です.
- メディケイドへの参加に関する小児科医の決定に影響を与える要因については,さらなる調査が必要である.
研究 の 目的:
- ノースカロライナ州のメディケイドプログラムへの小児科医の参加に影響を与える様々な要因の相対的な重要性を決定する.
主な方法:
- ノースカロライナの非学術的小児科医にアンケート調査が配布されました.
- この研究では,メディケイド患者へのアクセスを制限する小児科医の割合を評価し,影響要因を分析した.
主要な成果:
- 29%の小児科医がメディケイド患者へのアクセスを制限し,都市部ではその割合が高くなった.
- メディケイドの払い戻し,コミュニティのリソース,小児科医の態度,そして見られる仕事の負担は,参加に大きく影響した.
- メディケイドの払い戻しに関する知識が少ない小児科医は,アクセスを制限する可能性が高くなりました.
結論:
- メディケイドへの小児科医の参加は複雑で,コミュニティのリソース,経済的要因,実践規範の影響を受けます.
- メディケイドの払い戻しを強化するだけでは,わずかな改善をもたらすだろう;戦略は,教育とコミュニティの医師の関与にも焦点を当てなければならない.
- 小児科医の知識と認識を重視することは,メディケイド参加率を改善するために不可欠です.
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