气管切除术相关的耐用医疗设备:保险覆盖,缺口和障碍
Palmer L Foran1, William J Benjamin2, Ethan D Sperry3
1Department of Otolaryngology-Head & Neck Surgery, Johns Hopkins University, Baltimore, MD, United States.
American journal of otolaryngology
|December 20, 2023
概括
气管切除术耐用医疗设备的保险覆盖范围广泛,但存在重大障碍. 患者面临着可变成本,缺乏透明度和信息质量差,阻碍了获得必需物资的机会.
科学领域:
- 卫生政策研究 卫生政策研究
- 持久医疗设备的访问 持久医疗设备的访问
- 患者倡导 患者倡导
背景情况:
- 气管切除术护理是资源密集型的,由于气道相关的不良事件,其再入院和死亡率很高.
- 耐用医疗设备 (DME) 经常与患者的伤害有关,但保险覆盖和访问障碍的了解很少.
- 识别这些障碍对于改善患者的治疗结果和减少医疗保健负担至关重要.
研究的目的:
- 通过保险计划的覆盖,确定患者在获得气管切除术相关的耐用医疗设备时所面临的障碍.
- 为了评估保险覆盖的范围和关联的费用,基本的气管切除术供应.
- 评估保险公司关于DME.ME提供的信息的透明度和质量.
主要方法:
- 通过结构化的电话采访和网络搜索,对11家保险公司的DME条款进行了评估.
- 联系每家保险公司四次,询问保险和共同支付政策.
- 分析了电话持续时间,信息一致性,转移,并从患者访谈中确定了六个定性主题.
主要成果:
- 98.1%的计划提供了某种形式的气管切除术DME的保险,但42.6%的计划要求共同支付或扣除.
- 在自付费用方面存在显著的变化,共付费从0美元到40%不等.
- 电话采访显示长时间通话 (19分钟),多次转移 (2),信息变化很高 (2.4/1.5分);保险网站在可用性和信息质量方面得分很差.
结论:
- 获得拯救生命的气管切除术 (DME) 的障碍包括自付费用,缺乏覆盖透明度和信息质量差.
- 这些因素可能会限制患者获得必要的医疗设备.
- 需要进一步的研究来评估这些障碍对患者治疗结果的影响.
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