主治医による高齢者への予防サービスの提供
Hoangmai H Pham1, Deborah Schrag, J Lee Hargraves
1Center for Studying Health System Change, Washington, DC 20024, USA. mpham@hschange.org
JAMA
|July 28, 2005
まとめ
メディケア受給者に対する予防的ケアは,しばしば最適以下である. 収入源や医師のグループサイズなどの実務の特徴は,重要な健康診断とワクチン接種の提供に大きな影響を与えます.
科学分野:
- 医療サービス 研究 医療サービス
- 予防医学は,予防的な医療です.
- 保健政策 保健政策 保健政策
背景:
- メディケア受給者の予防的サービスの利用は,国家目標に及ばない.
- 予防ケアの質に影響を与える要因を特定することは,人口の健康状態を改善するために極めて重要です.
研究 の 目的:
- メディケア受給者による予防医療の質に関連する医師および実務の特徴を決定する.
- 特定の診療環境と医師の属性を特定し,予防的サービス提供の変動と関連付けます.
主な方法:
- メディケア請求に関連する2000-2001年コミュニティ・トラッキング・スタディの医師調査データの横断分析.
- 3660人の医師と,65歳以上のメディケア受給者24,581人を含む.
- 6つの主要な予防サービスを受ける受益者の割合を評価し,患者とコミュニティの要因を調整した.
主要な成果:
- 予防サービスの全体的な提供は,国家目標を下回っていた.
- 診療所の種類とメディケイドからの収入の割合は,サービス提供と強く関連していました.
- メディケイドの収入が低い診療所の受給者は,より多くの糖尿病の眼科検査,A1cモニタリング,マンモグラフィー,ワクチン接種を受けた.
結論:
- メディケア受給者に対する予防的ケアの提供は最適ではない.
- 特定の診療環境や医師のサブグループでは,質が低いケアを受けるリスクが高くなります.
- 高リスクの慣行に対する標的の介入は,予防サービスの質を向上させることができます.
関連する概念動画
01:26Methods Of Healthcare Delivery System
3.9K
At the different levels of the healthcare system, we see varying methods of healthcare used. These methods include managed care systems, case management, and primary healthcare.
Managed Care System:
The managed care system is designed to control the cost while maintaining the quality of care. The patient's care from admission to discharge is planned by the primary care provider or the case manager, also known as the gatekeeper. In a managed care system, the number of care providers is...
Managed Care System:
The managed care system is designed to control the cost while maintaining the quality of care. The patient's care from admission to discharge is planned by the primary care provider or the case manager, also known as the gatekeeper. In a managed care system, the number of care providers is...
3.9K
01:26Traditional Level Of Health Care System
3.4K
The levels of care describe the services provided in the healthcare system. Accordingly, there are six levels of the traditional healthcare system in the US: preventive, primary, secondary, tertiary, restorative, and continuing healthcare. A nurse must understand how the healthcare industry organizes and provides services within these levels of care.
The preventive healthcare service includes tests for screening. Preventive health care services include identifying and reducing disease risk...
The preventive healthcare service includes tests for screening. Preventive health care services include identifying and reducing disease risk...
3.4K
01:30Primary Healthcare Services
3.3K
Primary care promotes wellness and prevents disease. This care includes health promotion, education, protection (such as immunizations), early disease screening, and environmental considerations. Settings providing this type of healthcare include physician offices, public health clinics, school nursing, and community health nursing.
In 1978, international leaders convened in Alma-Ata, Kazakhstan, for what would be a pivotal event in global health. The Alma-Ata Declaration was the first to call...
In 1978, international leaders convened in Alma-Ata, Kazakhstan, for what would be a pivotal event in global health. The Alma-Ata Declaration was the first to call...
3.3K
01:30Preventive Healthcare Services
2.4K
Preventive healthcare services keep people healthy via frequent check-ups, screening, and counseling. They primarily aid in disease prevention rather than treating an acute or chronic illness. Preventive treatment also keeps individuals productive and energetic, allowing them to work well into their retirement years. Examples of preventive care services include:
2.4K
01:26Levels of Health Promotion and Illness Prevention
12.9K
Health promotion allows a person to control the determinants of health, resulting in an improved health status. It enhances the quality of life and reduces premature deaths. Health promotion and illness prevention programs help people make beneficial choices to reduce the risk of disease and disabilities. There are three health promotion and illness prevention levels: primary, secondary, and tertiary prevention.
In primary prevention, actions taken before disease onset prevent the disease from...
In primary prevention, actions taken before disease onset prevent the disease from...
12.9K
01:13Patient-centered Care
3.1K
Patient-centered care involves delivering care beyond inpatient hospitalization. Reflective practice can enhance a patient-centered approach. Reflective practice is a process of reasoning that considers all aspects of the present situation, including practicalities, learning from personal practice, and consideration of patient needs. Patients appreciate care decisions made while considering their input. Involving the patient in their care provides the patient with a sense of contribution rather...
3.1K