评估医疗补助管理护理网络的充分性标准和与专业护理的关联 儿童获得医疗补助管理护理的机会
Ju-Chen Hu1, Janet R Cummings2, Xu Ji3
1Ju-Chen Hu (jhu62@emory.edu), Emory University, Atlanta, Georgia.
Health affairs (Project Hope)
|June 5, 2023
概括
医疗补助管理护理的网络充足性标准并没有改善大多数儿童的专科护理机会. 然而,这些标准与护理人员对有特殊医疗需求的儿童的挫折感增加有关.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 儿科健康政策 儿科健康政策
- 管理护理管理护理
背景情况:
- 医疗补助管理护理计划为超过80%的入学儿童提供服务,其中包括许多有特殊医疗保健需求 (CSHCN) 的儿童.
- 联邦法规要求各州制定网络充足性标准,以提高医疗补助管理护理入学者的专业护理机会.
- 了解这些标准对CSHCN的影响对于政策制定至关重要.
研究的目的:
- 检查定量网络充足性标准与医疗补助计划儿童获得专科护理的相关性.
- 根据这些标准,专门评估特殊医疗需求儿童 (CSHCN) 的结果.
- 确定网络充足性标准的潜在意想不到的后果.
主要方法:
- 使用了近乎实验性的设计,采用了2016-2019年全国儿童健康调查数据.
- 分析了来自18个州的8614名医疗补助儿童的数据,其中包括3157名CSHCN.
- 评估结果,如专家访问 (非精神健康和心理健康),未满足的医疗保健需求和护理人员的丧.
主要成果:
- 在采用定量网络充足性标准和改善一般医疗补助计划儿童人口获得专业护理之间没有发现任何关联.
- 在CSHCN中,采用定量标准与增加护理人员在获取服务方面的丧有关.
- 这种挫折感在接受非精神卫生专家护理的CSHCN中尤为明显.
结论:
- 当前的定量网络充足性标准可能无法有效地改善所有医疗补助计划儿童获得专科护理的机会.
- 对于有特殊医疗需求的儿童来说,这些标准可能会无意中增加照顾者的负担和挫折感.
- 除了网络充足性标准之外,可能还需要进行额外的干预,以确保CSHCN获得公平有效的专业护理.
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