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随着时间的推移,医疗保险的趋势 皮肤病学高级实践临床医生,2013-2020年
Cassandra Mohr1, Yao Li1, Candice L Hinkston1
1Department of Health Services Research, University of Texas MD Anderson Cancer Center, Houston.
JAMA dermatology
|July 5, 2023
概括
高级实践临床医生 (APC) 越来越多地提供皮肤病护理,他们对皮肤病工作人员和患者访问的贡献从2013年到2020年大幅增加. 这一趋势凸显了皮肤病学领域不断变化的劳动力动力.
科学领域:
- 皮肤病学 皮肤病学
- 医疗保健服务研究 医疗服务研究
- 健康劳动力研究 卫生劳动力研究
背景情况:
- 在美国,高级实践临床医生 (APC) 的数量,包括执业护士和医生助理,正在增长.
- 皮肤病学医疗器械对皮肤病学工作人员和患者护理的影响尚不清楚.
研究的目的:
- 在医疗保险索赔数据中开发和验证一种用于识别在医疗保险索赔数据中从事皮肤病治疗的APC的方法.
- 评估皮肤病学APC对员工和患者访问的贡献.
主要方法:
- 使用医疗保险提供者利用和支付数据 (2013-2020) 的回顾性队列研究.
- 开发并验证了一种新的方法,使用皮肤病学程序代码来识别APC.
- 分析了使用曼-肯德尔和Joinpoint分析的临床医生比例和办公室访问的趋势.
主要成果:
- 鉴定方法的准确性很高 (96% PPV,100%的灵敏度/特异性).
- 在2013-2020年期间,皮肤病学临床医生的比例是APC,从27.7%增加到37.0%.
- 在研究期间,APC在皮肤病诊所中占有越来越多的份额,从15.5%上升到27.4%,其年增长率高于医生皮肤病学家.
结论:
- 在医疗保险系统内,APC提供的皮肤病护理的时间增加显著.
- 这些发现表明皮肤病学工作人员组成和实践模式发生了重大变化.
- 护肤剂日益增长的作用对皮肤病学作为一个专业的未来有潜在的影响.
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