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根据保险状况在马萨诸塞州和马里兰州的可避免住院率
J S Weissman1, C Gatsonis, A M Epstein
1Department of Medicine, Brigham and Women's Hospital, Boston, MA 02115.
JAMA
|November 4, 1992
概括
与私人保险人相比,无保险和医疗补助患者的可避免住院率更高. 这凸显了弱势群体在医疗保健获取和质量的差异.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 公共卫生 公共卫生
- 卫生经济学 卫生经济学
背景情况:
- 获得医疗保健是健康结果的关键决定因素.
- 保险状况对护理的利用率和质量产生重大影响.
- 可避免住院 (AHC) 是医疗保健系统绩效的一个关键指标.
研究的目的:
- 为了比较无保险,医疗补助和私人保险患者中可避免的病症的住院率.
- 根据保险状况确定医疗保健获取和质量的差异.
主要方法:
- 1987年马萨诸塞州和马里兰州的医院出院数据的横截面分析.
- 包括65岁以下的患者,不包括产科和精神疾病.
- 根据年龄和性别标准化招生率,并根据基线利用情况进行调整.
主要成果:
- 没有保险和医疗补助的患者在12种可避免的医院条件 (AHC) 中住院率明显更高.
- 与两个州的私人保险人相比,无保险人和医疗补助组的费率始终更高.
- 调整后的分析证实了大多数AHC的统计学上显著的差异,强调了访问和质量问题.
结论:
- 研究结果表明,缺乏保险或医疗补助计划的覆盖与可避免的住院病例的增加有关.
- 该研究的方法提供了一个潜在的框架,用于对特定患者群体的医疗保健获取和质量的常规监测.
- 解决保险覆盖缺口对于减少可预防的住院病例和改善人口健康结果至关重要.
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