基于学校的健康中心,获得护理和基于收入的不平等
Michel Boudreaux1, Jun Chu2, Brandy J Lipton3
1Department of Health Policy and Management, University of Maryland, College Park.
JAMA network open
|September 18, 2023
概括
基于学校的卫生中心 (SBHC) 改善了低收入儿童的医疗保健,增加了牙医诊所,保险和通常的护理来源. 采用SBHC显著减少了这些地区基于收入的差异,支持进一步扩张.
科学领域:
- 公共卫生 公共卫生
- 医疗保健服务研究 医疗服务研究
- 儿科健康 儿科健康
背景情况:
- 学校医疗中心 (SBHC) 是学校的初级保健诊所,旨在改善医疗保健准入和减少差距.
- 关于国家SBHC有效性的严格证据是有限的.
研究的目的:
- 评估县级SBHC采用与低收入儿童获得医疗保健,利用和健康结果之间的关联.
- 量化减少医疗保健获取和利用方面的基于收入的差异.
主要方法:
- 一个差异差异研究设计,使用全国代表性的调查数据 (1997-2018).
- 分析包括来自低收入家庭 (<200%联邦贫困水平) 和高收入家庭的5-17岁儿童.
- 在2003-2013年间采用SBHC的县的结果与没有SBHC的县的结果进行了比较.
主要成果:
- 采用SBHC与增加的牙科诊所 (+6.4%),通常的护理来源 (+8.0%) 和保险费率 (+5.2%) 相关.
- SBHC与牙医诊所 (76%),保险 (63%) 和通常的护理来源 (98%) 的收入差异显著相对减少有关.
- 对于其他测量的健康或利用结果,没有发现显著的关联.
结论:
- 采用SBHC与改善医疗保健准入和减少儿童收入差距有关.
- 调查结果支持扩大学校医疗中心,以加强儿童医疗保健的获取和公平.
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