在儿科阻塞性睡眠呼吸暂停治疗中,社会人口差异和医疗保健利用率
Jungwon Min1, Xuemei Zhang1, Heather M Griffis1
1Children's Hospital of Philadelphia, Philadelphia, PA, USA.
Sleep medicine
|July 21, 2023
概括
医疗补助保险儿童在阻塞性睡眠呼吸暂停 (OSA) 护理方面面临差异,没有治疗的几率更高,专业护理的几率更低. 对OSA的手术护理与减少医疗保健利用率有关.
科学领域:
- 儿科健康 儿科健康
- 医疗保健服务研究 医疗服务研究
- 睡眠医学 睡眠医学
背景情况:
- 阻塞性睡眠呼吸暂停 (OSA) 影响儿童,照顾的机会可能因保险和人口统计学而异.
- 了解OSA护理中的差异对于儿童群体的公平健康结果至关重要.
研究的目的:
- 根据保险覆盖范围,检查儿童在OSA护理途径中的差异.
- 分析医疗补助保险儿童 (MIC) 中的OSA护理的种族和种族差异.
- 评估OSA护理后医疗保健利用的变化.
主要方法:
- 对2017年被诊断患有OSA的2至17岁儿童的IBM MarketScan保险索赔进行分析.
- 包括1年的诊断前后数据,根据年龄,性别,肥胖和慢性疾病进行调整.
- 在医疗补助保险儿童 (MIC) 和商业保险儿童 (CIC) 之间比较OSA护理途径和医疗保健利用率.
主要成果:
- 34.4%的儿童没有接受OSA护理;MIC与CIC相比,没有护理的几率更高,特殊护理途径的几率更低.
- 在MIC中,接受手术护理的可能性更高,不需要多睡眠图 (PSG) 或仅PSG.
- 在MIC中,与白人儿童相比,黑人和西班牙裔儿童获得专科护理/PSG的几率更高,但手术的几率较低.
结论:
- 保险覆盖面对儿童的OSA照顾和参与有重大影响,这表明存在潜在的差异.
- 手术性OSA治疗与门诊和急诊医疗利用率下降有关.
- 需要进一步调查黑色MIC的较低外科手术率,考虑到OSA的严重程度,偏见和偏好.
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