完全整合双重符合条件的特殊需求计划与非完全整合计划的入学者之间的医疗保健利用差异
Hyunjee Kim1, Angela Senders1, Clint Sergi1
1Center for Health Systems Effectiveness, Oregon Health & Science University, Portland, Oregon, USA.
Journal of the American Geriatrics Society
|April 6, 2024
概括
与非FIDE计划相比,完全集成的双重符合条件 (FIDE) 计划没有显示出整体医疗保健利用率差异. 然而,FIDE计划减少家庭和社区服务用户的住院治疗.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 老年学是一门学科.
- 公共卫生政策 公共卫生政策
背景情况:
- 政策制定者促进护理整合模式,以改善双重符合条件的个人 (医疗保险和医疗补助) 的服务协调.
- 完全集成的双重符合条件 (FIDE) 计划,一种双重符合条件的特殊需求计划 (D-SNP),正在扩大,母保险公司管理医疗保险和医疗补助费用.
- 这项研究比较了FIDE和非FIDE计划之间的医疗保健利用率,针对65岁以上的个人.
研究的目的:
- 检查FIDE计划和非FIDE计划中65岁以上双重符合条件的个人在医疗保健利用方面的差异.
- 评估综合护理模式对服务提供和患者结果的影响.
主要方法:
- 分析了2018年6个州的FIDE和非FIDE入学者的Medicare Advantage遭遇和Medicaid索赔情况.
- 医疗保健利用率的比较,调整为入学者特征和县指标.
- 应用倾向性得分权重,以减轻计划类型之间的选择偏差.
主要成果:
- 在FIDE和非FIDE计划注册者之间没有观察到医疗保健利用的总体显著差异.
- 亚组分析显示,使用家庭和社区服务 (HCBS) 的FIDE入学者住院次数较少 (每1000人月减少6.0次).
- 在FIDE计划中的HCBS用户在住院后更有可能在家出院 (7.0个百分点).
结论:
- 虽然整体利用率相似,但FIDE计划显示了对特定子组的潜在好处,例如HCBS用户.
- 医院住院次数减少和HCBS使用者的家庭出院次数增加,表明FIDE计划中对这一群体的护理协调有所改善.
- 调查结果表明,FIDE计划可以加强对双重符合条件的个人某些子集的护理协调.
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