社区的社会脆弱性和340B药品定价计划:评估340B参与的预测因素在关键访问医院
Kelsey M Owsley1, Saleema A Karim2
1Department of Health Policy and Management, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA.
在社会脆弱地区的临界接入医院 (CAH) 不太可能参与340B药品定价计划. 这可能会使弱势群体无法从关键的药物成本节约中获益.
科学领域:
- 医疗服务研究 医疗服务研究
- 农村卫生政策 农村卫生政策
- 药品获取方式 药品获取方式
背景情况:
- 340B药品定价计划为符合条件的医院提供折扣的门诊药物,包括关键访问医院 (CAH).
- CAH通常服务于资源不足和脆弱的人群,使340B参与具有潜在的益处.
- 了解影响CAH参与340B的因素对于公平的药物获取至关重要.
研究的目的:
- 确定CAH中340B计划参与的预测因素.
- 检查社区层面的社会脆弱性与CAH参与340B计划之间的关系.
主要方法:
- 采用了横截面研究设计.
- 分析了来自CDC的2018年社会脆弱性指数 (SVI) 的数据和2019年急性护理CAH的340B参与数据.
- 使用了根据医院特征调整的线性概率模型.
主要成果:
- 在社会脆弱性较高的地区的CAH,特别是由于社会经济地位和少数民族/语言地位,显示340B参与率下降.
- 更高的医院运营利与340B参与度的增加有关.
- 在高度脆弱地区的非参与CAH的社会脆弱性得分更高.
结论:
- 高社区脆弱性地区的CAH参与340B计划的可能性较低.
- 这种差异可能导致弱势患者群体被排除在340B计划的好处之外.
- 可能需要有针对性的战略来增加CAH服务于弱势社区的340B参与率.
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