在商业保险人口中,健康和高成本利用的社会决定因素
Elena Andreyeva1, Winnie Chi, Yongkang Zhang
1Department of Health Policy and Management, School of Public Health, Texas A&M University, 212 Adriance Lab Rd, 1266 TAMU, College Station, TX 77843-1266.
添加社区健康社会决定因素 (SDOH) 数据并没有改善对高成本医疗保健利用的预测. 然而,处境不利的社区与更高的成本有关,特别是对于老年人来说.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 公共卫生 公共卫生
- 卫生经济学 卫生经济学
背景情况:
- 预测高成本医疗保健利用率对于资源配置至关重要.
- 社区健康的社会决定因素 (SDOH) 可能会影响医疗保健成本.
- 了解不同年龄组医疗保健利用率的差异是很重要的.
研究的目的:
- 评估邻近的SDOH数据是否能够在与人口和临床因素相结合时提高高成本医疗保健利用率的预测.
- 调查社区SDOH和高成本利用之间的关联如何因年龄而异.
主要方法:
- 一项观察性研究利用了2017-2018年美国人口普查数据和商业保险索赔.
- 使用Probit模型来评估社区SDOH对预测高成本利用的影响.
- 这项研究包括一个大样本的商业保险人,年龄在89岁以下.
主要成果:
- 邻里SDOH数据并没有显著提高高成本利用模型的预测准确性.
- 居住在弱势社区独立地与成为高成本的使用者有关.
- 贫困社区的老年人 (65岁以上) 显示使用高成本的可能性增加,而年轻人显示风险降低.
结论:
- 通过将其添加到现有模型中,SDOH对高成本利用的预测值没有得到改善.
- 处境不利的社区环境与更高的医疗保健成本有关,与年龄相关的差异很大.
- 政策制定者和利益相关者需要了解社区条件,健康结果和年龄之间的复杂关系.
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