在卫生保健专业人员短缺地区的医疗保健利用和支出
1Agency for Healthcare Research and Quality, Rockville, MD, USA.
Medical care research and review : MCRR
|March 15, 2024
概括
卫生专业人员短缺地区 (HPSA) 将医疗办公室访问减少5%,特别是在城市地区的老年,黑人和医疗补助患者. 支出和医院护理没有受到影响,突出了有针对性的访问问题.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 医疗保健政策 医疗保健政策
- 公共卫生 公共卫生
背景情况:
- 医疗保健提供者短缺与由于有限的初级保健准入而导致的负面健康结果有关.
- 卫生专业人员短缺地区 (HPSA) 是面临医疗服务提供者短缺的指定地区.
研究的目的:
- 调查HPSA对医疗保健利用和支出的影响.
- 为了确定不同的人口结构和护理类型中这些影响的差异.
主要方法:
- 2002-2019年利用的医疗支出小组调查数据.
- 采用了通用的随机森林模型来分析HPSA和非HPSA之间的医疗保健利用差异.
- 检查了异构的治疗效应,以了解各种影响.
主要成果:
- HPSA与医疗办公室访问减少5%有关.
- 没有观察到医院护理利用率有显著的减少.
- 影响集中在城市地区的老年人,黑人和医疗补助受益人群中.
- 没有发现年度医疗保健支出有统计学意义的变化.
结论:
- 高血压患者不成比例地影响弱势群体获得门诊护理的机会.
- 需要有针对性的干预措施来解决供应商短缺问题,并改善服务不足地区的医疗保健接入.
- 调查结果表明,应该将政策努力集中在HPSAs内的初级保健准入上.
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