更新慢性疾病和残疾支付系统
1Herbert Wertheim School of Public Health and Human Longevity Science, University of California, La Jolla, CA.
Medical care
|January 5, 2024
概括
更新的慢性疾病和残疾支付系统 (CDPS) 模型使用了最近的医疗补助数据. 在此分析中,没有发现健康指标的社会决定因素能够预测医疗保健支出.
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:
- 慢性疾病和残疾支付系统 (CDPS) 被38个州医疗补助计划中的33个用于风险调整.
- 越来越多的人对将健康的社会决定因素 (SDH) 纳入医疗风险调整模型感兴趣.
研究的目的:
- 更新CDPS模型以最新的国际疾病分类第10版 (ICD-10) 来自Medicaid管理护理组织 (MCO) 的编码数据.
- 调查SDH指标对Medicaid人口中的医疗保健支出的预测能力.
主要方法:
- 利用了来自8个州的140万名残疾受益者,920万儿童和640万成年人的医疗保健资格和索赔记录 (2017-2019).
- 使用ICD-10代码更新了CDPS模型,并评估了医疗保健支出与社会贫困指数 (SDI) 之间的关系.
主要成果:
- 修订后的CDPS模型包括19个主要组中的52个类别,在6个主要类别 (精神病,肺,脏,癌症,传染病,血液学) 中进行了重大修订.
- 医疗保健支出与社会贫困指数之间没有统计学上显著的关系.
结论:
- 修订后的CDPS模型包括更新的ICD-10编码和当前的托管护理实践.
- 各国应探索替代支付策略,以有效解决健康差异并改善健康结果.
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