在医疗保险优势,传统医疗保险之间的条件中,在资源使用方面的差异存在很大差异
Jeah Jung1, Caroline S Carlin2, Roger Feldman3
1Jeah Jung (jjung41@gmu.edu), George Mason University, Fairfax, Virginia.
Health affairs (Project Hope)
|September 5, 2023
概括
医疗保险优势 (MA) 通常使用的资源比传统医疗保险少,但差异因情况而异. 医院住院服务驱动了这些变化,MA的成像使用率更高.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 卫生经济学 卫生经济学
- 政策分析 政策分析
背景情况:
- 医疗保险优势 (MA) 是医疗保险受益人健康保险的重要和不断扩大的来源.
- 评估MA与传统医疗保险相比的表现对于政策制定至关重要.
研究的目的:
- 为了比较医疗保险优势和传统医疗保险之间的资源利用率.
- 识别导致医疗条件之间资源使用差异的因素.
主要方法:
- 从2019年开始对国家Medicare Advantage遭遇数据的分析.
- 调整了MA和传统医疗保险之间的资源使用比较.
主要成果:
- 在MA的总资源使用率通常低于传统的医疗保险,在各种疾病中存在显著的差异.
- 差异在很大程度上是由医院住院服务利用率解释的.
- 在MA中,治疗资源使用率较低,而在所有疾病中,成像和测试资源使用率更高.
结论:
- 在MA和传统医疗保险之间的资源使用存在显著差异,受住院护理的影响.
- 了解这些驱动因素是必不可少的,因为MA招生人数不断增长.
- 进一步的研究应该探索对患者护理和成本效益的影响.
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