通过基于社区的干预来提高服务不足人群的价值:一个回顾性队列研究
Claude Pinnock1, John Rothen2, Tom Carlough2
1Wider Circle, Redwood, CA, USA. cpinnock@widercircle.com.
一个以社区为基础的同行支持计划降低了医疗保健成本,并改善了非洲裔美国人医疗补助计划的会员保留率. 这种文化上有能力的干预措施也提高了获得预防护理的机会,证明了解决健康的社会决定因素的价值.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 健康 公平 卫生 公平
- 社区卫生干预措施 社区卫生干预
背景情况:
- 由健康的社会决定因素 (SDOH) 驱动的医疗保健不平等导致更高的成本和更差的结果.
- 基于社区的,具有文化能力的干预措施可以通过解决健康行为和SDOH来提高Medicaid入学者的价值.
- 本研究评估了此类干预的成本和质量影响.
研究的目的:
- 评估基于社区的同行支持计划的有效性.
- 确定该计划对临床,利用和财务结果的影响.
- 评估非洲裔美国人医疗补助计划注册者的成本节约和质量改进.
主要方法:
- 使用来自密歇根州底特律的索赔数据 (2021年4月至2022年4月) 的回顾性队列研究.
- 738对非裔美国人医疗补助计划入学者的倾向分数匹配.
- 对同行支持受益者和对照者之间的成本,利用和质量指标差异的比较.
主要成果:
- 获得同行支持的成员每月的每位会员费用显著降低 (减少115美元).
- 观察到成年人获得预防性/门诊医疗服务质量指标的显著增加 (8.31%).
- 获得同行支持的会员保留率明显高 (3.62%);其他质量指标显示没有显著差异.
结论:
- 在文化上有能力,以社区为基础的干预可以降低医疗补助入学者的成本.
- 这些干预措施与改善会员保留和加强对预防性护理的准入有关.
- 通过同行支持来解决SDOH,有望改善弱势群体的医疗保健价值.
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