医疗保险状态和无计划的手术对访问敏感的外科条件
Shukri H A Dualeh1,2, Sara L Schaefer1,2, Nicholas Kunnath2
1Department of Surgery, University of Michigan, Ann Arbor.
JAMA surgery
|February 7, 2024
概括
没有保险的患者更有可能需要在可选择性治疗的条件下进行非计划性手术,经历更糟糕的结果和更长的住院时间. 这凸显了保险公司在获得及时手术护理方面的差距.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 外科手术的结果
- 医疗保险政策 医疗保险政策
背景情况:
- 敏感的手术条件需要及时的选择性治疗,以防止计划外的手术.
- 患者的健康保险状况可能是获得选择性外科护理的重要障碍.
- 没有保险或保险不足的患者可能面临更高的意外手术率和不良结果.
研究的目的:
- 为了调查健康保险状况和3种访问敏感条件的无计划手术率之间的关联.
- 评估保险状况对为这些疾病接受手术的患者手术后后果的影响.
- 根据保险覆盖,确定手术护理获取和结果的差异.
主要方法:
- 采用医疗保健成本和利用项目从8个州的州住院患者数据库进行的横截面队列研究.
- 包括65岁以下接受腹腔大动脉动脉瘤修复,腹腔修复或结肠癌切除术的患者 (2016-2020年).
- 根据保险状况对患者进行分层 (私人,医疗补助,没有) 并分析计划外科手术率和术后结果.
主要成果:
- 总共有146,609名患者被纳入;39.3%接受了未计划的手术.
- 与私人保险 (33.14%) 患者相比,无保险 (72.60%) 和医疗补助 (51.46%) 患者的非计划性手术率明显高.
- 非保险患者的住院死亡率,并发症率和住院时间比私人保险患者高.
结论:
- 没有保险的患者不成比例地接受了可治疗的疾病的无计划手术,面临着更差的结果.
- 医疗保险状况是及时获得选择性手术和术后结果的关键决定因素.
- 监测选择性与非计划性手术率对于访问敏感条件的监测对于评估医疗保健获取改善至关重要.
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