通过医院保险连接计划追溯保险的患者在医疗保健中的使用
Ella C Eisinger1,2, Angela T Chen1,2,3, Omar I Ramadan1,2
1The Center for Surgical Health, University of Pennsylvania, Philadelphia, PA, USA.
Journal of general internal medicine
|March 14, 2024
概括
医院保险连接计划将没有保险的患者连接到医疗补助,增加初级保健访问和急性护理利用率. 这些计划对于通过将患者与基本医疗保健服务联系起来来改善健康结果至关重要.
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:
- 在美国,超过25%的无保险人有资格获得医疗补助.
- 医院保险连接计划帮助符合条件的患者进行入学.
- 这些计划对护理利用的影响尚不清楚.
研究的目的:
- 通过医院医疗保险链接评估医疗保健利用率和医疗健康结果.
- 将追溯保险患者的结果与以前有医疗补助或没有保险的患者进行比较.
主要方法:
- 对18-64岁的入院成人进行回顾性队列研究 (2016-2021年).
- 追溯获得保险 (RI) 的患者与先前有医疗补助 (MI) 或无保险 (UI) 的患者的比较.
- 主要结果:在12个月内访问初级保健提供者 (PCP). 二次结果:PCP分配,ED复诊,再接收,HbA1c和血压.
主要成果:
- 74.8%的无保险入院患者是通过保险连接 (RI) 加入的.
- 与心脏病患者相比,RI患者的PCP访问率比MI患者高14% (p=0.020).
- 没有保险的患者有29%更少的PCP访问 (p=0.003);MI和RI患者有更多的ED重访和更好的血压降低.
结论:
- 基于医院的保险连接有效地到达了没有保险的患者.
- 这些计划与急性和门诊医疗保健服务的使用率增加有关.
- 急性护理接触是将患者与保险联系起来,改善健康结果的机会.
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