医疗补助人口中社会需求的潜在阶级分析及其对风险调整模型的影响
Chintan J Pandya1, JunBo Wu2, Elham Hatef1,3
1Department of Health Policy and Management, Center for Population Health IT, Johns Hopkins School of Public Health, Baltimore, MD.
Medical care
|December 12, 2023
概括
在医疗补助人口中解决社会需求 (SNs) 改善了医疗保健风险调整. 识别安全和访问等SN类可以提高利用和成本的预测.
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
- 公共卫生政策 公共卫生政策
背景情况:
- 医疗补助管理护理计划越来越多地解决社会需求 (SNs).
- 整合SN可能会增强医疗补助补偿的风险调整模型.
- 这项研究检查了大型医疗补助人口中的SN.
研究的目的:
- 在医疗补助人口中确定不同类别的SN.
- 评估纳入SN类对医疗保健利用和成本风险调整模型性能的影响.
主要方法:
- 对262,325名医疗补助患者 (2018-2019) 的二次分析.
- 隐性类分析 (LCA) 用于识别SN类.
- 后勤和线性回归模型评估了在纳入SN类之前和之后的模型性能.
主要成果:
- 7.8%的患者报告至少有一个SN;安全需求是最普遍的 (3.9%).
- 确定了四个最佳的SN类:压力,安全,获得医疗保健和社会经济地位.
- SN课程改善了预测急诊室访问和住院的模型性能 (AUC增加).
结论:
- 纳入SN类显著增强了医疗保健利用和成本的风险调整模型.
- 进一步的研究是有必要的,以探索在不同的医疗补助人口中SN的预测价值.
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