医疗补助儿童对喘的医疗保健利用率与私人保险的差异
Sarah L Goff1, Meng-Shiou Shieh2, Peter K Lindenauer2,3
1Department of Health Promotion and Policy, School of Public Health & Health Sciences, University of Massachusetts Amherst, Amherst, Massachusetts, USA.
Population health management
|April 4, 2024
概括
与私人保险儿童相比,患有喘的医疗补助保险儿童的急性护理使用率更高,例行访问量更少. 这凸显了喘护理质量和低收入家庭获得护理的差异.
科学领域:
- 儿科喘管理 儿科喘管理
- 医疗保健服务研究 医疗服务研究
- 健康 公平 卫生 公平
背景情况:
- 喘是一种普遍的慢性儿童疾病,不成比例地影响低收入家庭,并推动急性护理利用率.
- 根据保险类型,喘儿童在医疗保健获取和质量方面存在显著差异.
研究的目的:
- 为了比较马萨诸塞州的医疗补助和私人保险的儿童之间的急性护理利用率和喘护理质量.
- 确定改善公共保险儿科患者喘管理的具体领域.
主要方法:
- 使用马萨诸塞州所有付款人索赔数据库 (2014-2018) 的回顾性队列研究.
- 分析急性护理使用情况 (急诊室访问,住院),常规喘访问和喘药物处方.
- 多变量后勤回归调整为人口,社会经济,健康状况和喘严重程度因素.
主要成果:
- 与私人保险儿童相比,医疗补助保险儿童的急性护理使用率 (50.4%对30.0%) 和喘相关的急诊室访问率 (27.2%对13.3%) 较高.
- 与私人保险儿童 (74.3%) 相比,医疗补助保险儿童 (65.4%) 的例行喘检查较少.
- 虽然大多数儿童至少接受了一种喘药物,但医疗补助计划的入学者不太可能接受控制药物 (46.1%和49.2%).
结论:
- 对于医疗补助保险儿童来说,喘护理的利用率和质量仍然存在显著差异.
- 需要有针对性的干预措施来改善医疗补助计划覆盖的儿科喘患者的日常护理和控制器药物坚持.
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