怀孕期间的保险覆盖和不连续性:在PROMISE队列中记录的频率和关联
Anna Booman1, Kalera Stratton1, Kimberly K Vesco2
1School of Public Health, Oregon Health & Science University-Portland State University, Portland, Oregon, USA.
Health services research
|December 20, 2023
概括
在怀孕期间,保险中断是常见的,影响了护理准入和结果. 持续的公共保险是最常见的,但也与不充分的产前护理有关,突出了动态的保险需求.
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
- 医疗保险政策 医疗保险政策
背景情况:
- 怀孕期间的保险模式和不连续性可能会影响孕妇获得护理,持续性和健康结果.
- 了解这些动态对于改善产周护理和孕产妇健康至关重要.
- 社区医疗保健组织 (CHCO) 服务于不同的人群,使其成为研究保险相关护理差异的关键地点.
研究的目的:
- 描述在美国的CHCO接受护理的孕妇中保险模式和不连续性.
- 分析怀孕期间保险变化的频率和时间.
- 探索保险模式与产前护理利用之间的关系.
主要方法:
- 使用PROMISE研究 (2005-2021) 纵向电子健康记录数据进行的描述性队列研究.
- 保险状态 (私人,公共,无保险) 在每个遭遇中都被记录下来.
- 孕妇被按保险模式分类,并分析了变化/利用情况.
主要成果:
- 持续的公共保险是最常见的模式 (69.2%).
- 保险中断影响了16.6%的孕妇,通常涉及到向公共保险过渡.
- 持续的公共保险与较高的不充分的产前护理 (19.5%) 相关,同时所有三种保险类型与密集的产前护理 (16.5%) 相相关.
结论:
- 在寻求CHCO护理的孕妇中,保险中断和不保险很普遍.
- 怀孕期间的保险状况是动态的,应该相应地衡量.
- 需要进一步的研究,以了解围产期保险中断对健康结果的驱动因素和影响.
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