保险状况和获得紧急门诊护理的机会 随访预约 随访预约
Brent R Asplin1, Karin V Rhodes, Helen Levy
1Department of Emergency Medicine, Regions Hospital and HealthPartners Research Foundation, St Paul, Minn 55101, USA. Brent.R.Asplin@HealthPartners.com
JAMA
|September 15, 2005
概括
保险状况显著影响到紧急门诊随访护理的获取. 私人保险患者比医疗补助患者更容易获得预约,但支付现金并不总是保证及时预约.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 卫生经济学 卫生经济学
- 健行护理服务提供者
背景情况:
- 越来越多的压力来减少急诊室 (ED) 患者的住院治疗.
- 安全的门诊治疗依赖于及时获得后续护理.
- 对保险状况对后续预约访问的影响的理解有限.
研究的目的:
- 调查报告的保险状况与获得后续预约之间的关联.
- 关注ED中常见的严重疾病.
- 评估及时门诊护理的障碍.
主要方法:
- 八名研究助理扮演新患者,需要紧急随访 (在1周内) 肺炎,高血压或异胎妊娠.
- 在美国9个城市调用了499个随机选择的门诊诊所.
- 模拟患者场景的各种报告的保险状况 (私人,医疗补助,没有付款选择的无保险人).
主要成果:
- 430家诊所完成了这项研究. 只有47.2%的呼叫者在一周内得到了预约.
- 私人保险呼叫者 (64.4%) 比医疗补助呼叫者 (34.2%) 更有可能获得预约.
- 提供现金支付的无保险呼叫者与私人保险呼叫者有相似的预约率,但提供部分支付的呼叫者的预约率要低得多.
结论:
- 报告的保险状况是获得严重疾病及时门诊随访护理的重要因素.
- 虽然私人保险改善了获取机会,但并没有消除差距.
- 愿意支付现金改善了无保险患者的获取机会,但不一致,突出了系统性障碍.
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