2010-2019年双重符合条件的特殊需求计划的公开报告质量表现,2010-2019年
Laura M Keohane1, Srivarun Tummarakota2
1Department of Health Policy, Vanderbilt University School of Medicine, Nashville, TN, USA.
Journal of aging & social policy
|June 22, 2023
概括
双重资格的特殊需求计划 (D-SNP) 的质量得分略低于医疗保险优势计划,但在2010-2019年间,差距缩小了. D-SNP还报告了不完整的数据,强调需要在管理护理质量方面提高透明度.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 管理的护理质量 管理的护理质量
- 卫生政策 卫生政策
背景情况:
- 双重资格的特殊需求计划 (D-SNP) 服务于符合医疗保险和医疗补助的低收入个人.
- 增加D-SNP的入学人数需要对其护理质量的强有力的证据.
- 与更广泛的医疗保险优势 (MA) 计划相比,有关D-SNP质量的现有数据有限.
研究的目的:
- 与整体医疗保险优势计划相比,评估D-SNP提供的护理质量.
- 分析2010年至2019年期间D-SNP质量绩效和报告完整性的趋势.
主要方法:
- 利用了公开报告的医疗保健有效性数据和信息集 (HEDIS) 措施,从2010-2019年.
- 在D-SNP和整体MA合同之间比较了D-SNP和整体MA合同之间的HEDIS绩效中位数.
- 评估了D-SNP和MA合同的业绩报告的完整性.
主要成果:
- 与整体MA计划相比,D-SNP的HEDIS绩效平均得分一般略低一些.
- D-SNP和MA合同之间的质量绩效差距在2010年至2019年之间有所减少.
- D-SNP的业绩报告比MA合同更不完整,特别是在临床状况测量方面.
结论:
- D-SNP表明需要提高质量表现和报告透明度.
- 目前的医疗保险优势报告要求可能无法充分捕捉D-SNP的特定性能.
- 提高D-SNP绩效报告的透明度对于确保双重资格受益人的护理质量至关重要.
相关概念视频
Specialized Care Centers and Settings-II
757
Rural Health Centers
Rural health centers are specialized care facilities in remote locations with very few medical personnel. The primary care providers who run the centers are mostly Registered Nurse Practitioners. Here, emergency treatment is provided to critically ill or injured patients before they are transferred to the closest hospital. Fortunately, due to advancement in technology, many rural healthcare facilities and professionals have easy access to diagnostic and treatment...
Rural health centers are specialized care facilities in remote locations with very few medical personnel. The primary care providers who run the centers are mostly Registered Nurse Practitioners. Here, emergency treatment is provided to critically ill or injured patients before they are transferred to the closest hospital. Fortunately, due to advancement in technology, many rural healthcare facilities and professionals have easy access to diagnostic and treatment...
757
Specialized Care Centers and Settings-I
977
Specialized care settings or centers are situated in convenient locations within the community and offer care to a specific group or population. They consist of daycare facilities, mental health facilities, rural health facilities, educational institutions, industries, shelters for the homeless, and rehabilitation facilities.
Daycare centers
They provide several functions. Some facilities care for healthy newborns and children whose parents work, while others are medically focused and care for...
Daycare centers
They provide several functions. Some facilities care for healthy newborns and children whose parents work, while others are medically focused and care for...
977
Health Information Technology and Healthcare Information System
877
Health Information Technology (HIT)
Health Information Technology, commonly called HIT, integrates advanced information systems and technology in healthcare settings. Its primary functions include:
Health Information Technology, commonly called HIT, integrates advanced information systems and technology in healthcare settings. Its primary functions include:
877
Standards of Care I
731
Federal statutes profoundly impact nursing practice, providing critical guidelines to ensure patient care is equitable, accessible, and of the highest quality. The following laws address distinct aspects of healthcare provision and patient rights:
731
Documentation in Long-Term and Home Healthcare Setting
932
Documentation in long-term care facilities and home healthcare settings is crucial for ensuring continuous, coordinated, and comprehensive care for patients. Each setting has its specific documentation processes and tools:
Long-Term Care Facilities
Long-Term Care Facilities
932
Planning Nursing Care I
4.5K
The planning phase of the nursing process helps nurses set priorities, outline patient-centered goals and expected outcomes, and tailor nursing interventions to align with the aligned care plan. Through the planning phase, the nurse applies critical thinking skills to align and develop interventions according to the patient's needs. It provides continuity of care allowing patients to receive the maximum benefit from treatment. It serves as a pilot plan for allocating individual staff to a...
4.5K


