儿科医学子专家在门诊环境中使用
Christopher B Forrest1, Candice P Chen2, Eliana M Perrin3
1Applied Clinical Research Center, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania.
儿科医学子专业护理的使用因保险类型而异,在学术卫生系统中使用率更高. 商业保险的使用略有增加,而医疗补助的使用减少,突出了儿童获得机会的差异.
科学领域:
- 儿科卫生服务研究 儿童卫生服务研究
- 卫生经济学 卫生经济学
- 公共卫生 公共卫生
背景情况:
- 了解儿科医学小专科护理利用率对于评估医疗保健需求至关重要.
- 描述当前的使用率和时间趋势为评估服务交付提供了基线.
研究的目的:
- 量化儿童在门诊儿科医学子专业的使用率.
- 分析随着时间的推移,子专业护理的使用趋势.
主要方法:
- 一项重复的横截面研究利用了三个数据源:PEDSnet (电子健康记录),医疗保健综合研究数据库 (HIRD) (商业保险),以及转换的医疗补助统计信息系统 (T-MSIS) (医疗补助).
- 对21岁以下儿童每年对儿科医学子专家的门诊访问进行了检查.
- 包括来自学术医疗中心,商业健康计划和州医疗补助计划的大型患者队伍.
主要成果:
- 在PEDSnet中,每年使用次专业护理的比例为21.3%,在HIRD中为10.4%,在T-MSIS中为8.6%.
- 在商业医疗计划中,次专家使用量每年略有增加 (2.4%),但在学术医疗系统中保持相对平稳,在医疗补助受益者中略有下降 (-0.9%).
- 在不同类型的保险中观察到利用率的差异.
结论:
- 基于保险覆盖的儿科医疗子专业护理使用情况存在显著差异.
- 趋势表明,商业保险儿童的使用量略有增加,与医疗补助受益人数的下降形成鲜明对比.
- 这些发现强调了在初级专科护理接口上需要创新,以确保公平的获取.
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