医疗保险过渡期护理管理计划和及时出院后随访的变化
Timothy S Anderson1, Shoshana J Herzig2,3, Edward R Marcantonio2,3
1Department of Medicine, Division of General Internal Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania.
JAMA health forum
|April 12, 2024
概括
美国医疗保险 (Medicare) 的医疗保险.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 卫生政策 卫生政策
- 健行护理服务提供者
背景情况:
- 医疗保险在2013年引入过渡性护理管理 (TCM) 支付,以激励退院后的门诊护理.
- 这一政策旨在通过确保在住院或熟练护理设施后及时跟进来改善患者的结果.
研究的目的:
- 评估TCM支付对及时放免后后续访问率的影响.
- 确定TCM的实施是否影响了医疗保健获取方面的差异.
主要方法:
- 一项横断的,中断的时间序列研究分析了2010-2019年的医疗保险服务费用数据.
- 该研究包括超过7900万次出院,并比较了TCM支付实施前后的后续访问率.
主要成果:
- 在TCM实施后,及时的初级保健随访增加了7.3% (从31.5%增加到38.8%).
- 虽然整体随访情况有所改善,但黑人和医疗补助双重资格患者的差异仍然存在并扩大.
- 到2019年,只有11.3%的符合条件的患者获得了TCM服务.
结论:
- 医疗保险的TCM支付与更及时的出院后初级保健相关.
- 该政策没有减少,在某些情况下甚至扩大了现有的人口和社会经济差异.
- 很大一部分受益人仍然缺乏及时的解雇后后续行动.
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