在分娩后1年内与医院相遇 跨保险类型,俄勒冈州2012-2017年
Menolly Kaufman1,2, K John McConnell2, Maria I Rodriguez2,3
1School of Public Health, Oregon Health & Science University and Portland State University, Portland, OR.
医疗补助计划的患者比商业计划的患者有更多的产后紧急诊所和更少的产后诊所. 这表明,Medicaid受益人可能会遇到产后护理准入问题.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 孕产妇健康 孕产妇健康
- 医疗保险 医疗保险 医疗保险
背景情况:
- 在最初的6周之后,对产后护理利用模式的理解有限.
- 保险类型和产后护理的准入之间的关联没有得到充分研究.
研究的目的:
- 通过保险类型 (医疗补助,高扣除,商业) 来比较产后医院利用率和探访率.
- 为了检查产后访问出席率,保险状况和医院接触之间的关系.
主要方法:
- 俄勒冈州医院分娩 (2012-2017) 的分析,使用所有付款人所有索赔数据.
- 时间到事件分析与加权的考克斯比例危险回归.
- 多项式倾向分数与保险类型差异的控制匹配.
主要成果:
- 24.9%的新生儿在一年内至少有一次分娩后住院.
- 与商业计划相比,医疗补助分娩显示出更高的急诊室 (ED) 访问风险 (HR 2.05) 和更低的访问出席率 (HR 0.71).
- 在医疗补助受益者中,错过产后早期访问与重新入院 (aHR 0.77) 和ED访问风险 (aHR 0.87) 的降低相关.
结论:
- 医疗补助计划的受益人使用急诊室的产后护理比商业计划的受益人更频繁.
- 调查结果表明,医疗补助计划的入学者在分娩后护理获取方面存在潜在的差异.
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