在患有痴呆症的Medicare Advantage入学者中进行乳腺癌查
Eli Raver1, Wendy Y Xu1, Jeah Jung2
1Division of Health Services Management and Policy, College of Public Health, The Ohio State University, Columbus, OH, USA.
BMC health services research
|March 5, 2024
概括
医疗保险优势计划增加了患有痴呆症的老年妇女乳腺癌查乳房扫描的使用,特别是那些双重资格或居住在城市地区的老年妇女. 这可能会导致一些患者过度查的问题.
科学领域:
- 老年学是一门学科.
- 在瘤学瘤学.
- 医疗保健服务研究 医疗服务研究
背景情况:
- 患有痴呆症的老年人面临着关于乳腺癌查的复杂决策,原因是过度查的风险增加.
- 患有痴呆症的医疗保险受益者越来越多地注册医疗保险优势 (MA) 计划,这通常鼓励预防性查.
- 这项研究调查了在MA注册的痴呆症妇女中乳腺癌查的使用情况,与传统的服务费 (FFS) 医疗保险相比.
研究的目的:
- 为了比较医疗保险优势 (MA) 登记的痴呆症妇女中乳腺癌查乳房扫描的使用率,与医疗保险的服务费用 (FFS) 相比.
- 检查双重资格和地理位置 (城市/农村) 等因素如何影响这些人群的查率.
- 为了确定这些医疗保险计划中对认知障碍患者的乳房影像使用的潜在差异或趋势.
主要方法:
- 利用2012-2019年医疗保险当前受益者调查数据,采用了一个聚合的横截面研究设计.
- 该研究包括65-74岁的阿尔茨海默病和相关痴呆症或认知障碍的妇女,这些妇女有资格接受乳房影像.
- 普森回归模型估计了每两年使用一次乳房镜的流行率,按计划类型,农村地区和双重资格分层.
主要成果:
- 与FFS入学者相比,在患有痴呆症的MA入学者中,乳房扫描的利用率高出16% (PR 1.16).
- 城市MA入学者显示出乳房扫描率高出21% (PR 1.21),双重资格的MA入学者比他们的FFS同行有34%的更高率 (PR 1.34).
- 在农村登记者中,在MA和FFS之间没有观察到乳房扫描使用的显著差异,在非双重资格的个人中,率没有显著差异.
结论:
- 医疗保险优势入学与痴呆症妇女的乳房镜使用率更高有关,特别是双重资格的个人和城市地区的妇女.
- 这些发现表明,在一些患有痴呆症的医疗保险优势计划入学者中,可能存在过度查的可能性.
- 个性化查决策对于这个弱势群体来说至关重要,以平衡利益和危害.
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