医疗保险优势与整体关节关节整形术的使用率较低有关
Kelly E Anderson1,2, Rachel J Wu3, Michael Darden2,4,5
1Department of Clinical Pharmacy, Skaggs School of Pharmacy and Pharmaceutical Sciences, University of Colorado, Aurora, Colorado.
The Journal of bone and joint surgery. American volume
|November 16, 2023
概括
与传统的医疗保险相比,医疗保险优势注册者对关节和膝盖置换手术的利用率较低. 这包括医疗保险优势患者的外科医生咨询和手术等待时间更长.
科学领域:
- 整形外科手术 整形外科手术
- 医疗保健服务研究 医疗服务研究
- 卫生经济学 卫生经济学
背景情况:
- 医疗保险优势 (MA) 计划利用管理护理策略来控制成本.
- 对于MA对选择性手术程序的利用,特别是全关节整形术 (TJA) 的影响尚不清楚.
- 传统医疗保险 (TM) 覆盖TJA,但没有MA中常见的利用限制.
研究的目的:
- 为了比较医疗保险优势 (MA) 和传统医疗保险 (TM) 登记者之间的关节和膝关节全关节整形术 (TJA) 的利用率.
- 调查MA和TM入学者之间的骨科外科医生咨询和TJA外科手术的时间差异.
主要方法:
- 一项横截面研究分析了2018年医疗保险索赔和遭遇数据的20%样本.
- 其中包括5,300,188名传统医疗保险 (TM) 登记者和1,970,032名65-85岁的医疗保险优势 (MA) 登记者.
- 利用调整后的分析来控制受益者和市场特征,以比较TJA的发生率和时间.
主要成果:
- 医疗保险优势 (MA) 招生人与TM招生人相比,TJA的发病率降低了15.6% (p < 0.001).
- 在MA的健康维护组织 (HMO) 招生人比TM招生人有28.1%更少的发生TJA (p < 0.001).
- 马的入学者经历了更长的时间,骨科外科医生联系和手术后骨关节炎诊断手术程序.
结论:
- 医疗保险优势 (MA) 覆盖与选择性住院关节和膝关节全关节整形术 (TJA) 的使用率降低有关.
- MA入学与获得骨科护理和TJA程序的延迟增加有关.
- 研究结果表明,与TM受益者相比,MA受益者在手术护理获取方面存在潜在的差异.
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