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マネージドケアに転換する州のメディケイド機関による品質管理:計画と現在の実践
B E Landon1, C Tobias, A M Epstein
1Brigham and Women's Hospital, Department of Health Care Policy, Harvard Medical School, Boston, MA, USA.
JAMA
|January 23, 1998
まとめ
州のメディケイド機関は,管理ケアプランの品質モニタリングを強化しています. 多くの州は,より多くのデータを収集し,医療の質を改善するために,医療プランと受益者との情報を共有することを計画しています.
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
- 管理ケア 品質保証 管理ケア 品質保証
背景:
- メディケイド (Medicaid) のマネージドケア登録は著しく急増しています.
- これらのプログラムの品質に対する国家の監督を理解することは極めて重要です.
研究 の 目的:
- 州のメディケイド機関による品質モニタリングと品質保証活動を評価する.
- 総合的なプリペイドマネージドケアプログラムに重点を置く.
主な方法:
- マネージドケア登録の全34の州メディケイド機関 (およびDC) の構造化された電話調査.
- 1996年10月から1997年1月までの間に収集されたデータです.
主要な成果:
- 34州の全州で,扶養家族支援 (AFDC) の受給者が登録され,62パーセントが障害者,44パーセントが高齢者であった.
- 1995年から1996年にかけて,患者の満足度に関するデータ収集は63%で,小児予防接種に関するデータは83%でした.
- 多くの州は,1997年までにデータ収集を増やし,医療プランや受給者とのデータ共有を計画していた.
結論:
- 州のメディケイド機関は,医療購入者としての役割を積極的に発展させています.
- 継続的なモニタリングは,計画された質の高いイニシアチブが実施され,メディケイド登録者のケアが維持または改善されることを保証するために不可欠です.
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