可预防性住院趋势 在"负担得起的医疗法案"之前和之后
Shannon M Wood1, Molin Yue2, Sandra V Kotsis1
1Section of Plastic Surgery, Department of Surgery, University of Michigan Medical School, Ann Arbor, Michigan.
AJPM focus
|October 4, 2023
概括
负担得起的医疗保健法案和医疗补助计划的扩大大大减少了可预防的住院治疗. 优先考虑医疗补助扩张可能会进一步降低这些费率,并改善初级保健准入.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 公共卫生政策 公共卫生政策
- 卫生经济学 卫生经济学
背景情况:
- 患者保护和可负担医疗法案 (ACA) 的目的是增加医疗保险覆盖范围.
- 增加保险可能会改善获得初级保健的机会,并减少可预防的住院治疗.
- 医疗补助扩张是ACA战略的一个关键组成部分.
研究的目的:
- 评估 ACA 和随后的医疗补助扩张对可预防住院率的影响.
- 分析2005年至2017年期间26个州可预防住院病例的趋势.
主要方法:
- 基于人口的研究使用医疗保健成本和利用项目国家住院样本数据库 (2005-2017年).
- 后勤回归和趋势分析,以评估住院率的变化.
- 纳入标准:年龄在18-64岁之间,患有可预防疾病的个人 (ICD-9/10).
主要成果:
- 从2005年到2017年,有超过4500万例可预防的住院病例被记录在案.
- 可预防性住院率在ACA后 (12.0%至10.8%) 和医疗补助扩张后 (11.5%至10.6%) 显著下降.
- 细菌性肺炎,COPD和喘等特定疾病在医疗补助扩张后显著下降.
结论:
- 医疗补助计划的扩张与可预防的住院治疗减少有关.
- 各国应优先考虑医疗补助扩张,以改善人口健康结果.
- 可预防的住院率可以作为初级保健可访问性和有效性的质量指标.
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