医疗补助扩张的协会,在大批量中心为良性疾病提供甲状腺切除术
Alexander Manzella1, Marin Kheng1, Joshua Chao1
1Rutgers Robert Wood Johnson Medical School, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ.
Surgery
|May 18, 2024
概括
医疗补助扩张增加了覆盖范围,但并没有改善医疗补助患者获得大量甲状腺切除中心的机会. 这些患者仍然不太可能比私人保险患者在大量的中心接受护理,这表明持续存在的进入障碍.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 外科手术的结果
- 卫生政策 卫生政策
背景情况:
- 在甲状腺切除手术获得的机会中建立了基于保险的差异.
- 大量的外科医生可以改善甲状腺切除术的结果,并减少并发症.
- 对于良性甲状腺疾病手术的大量中心的准入是令人担忧的.
研究的目的:
- 为了评估医疗补助扩张和获得大量甲状腺切除中心的良性疾病之间的关联.
- 确定医疗补助计划的扩大是否能缓解获得大量手术护理的差异.
主要方法:
- 利用了Vizient临床数据库用于成人良性甲状腺疾病手术 (2010-2019).
- 将中心分类为体积四分位数,并分析保险人群.
- 采用差异差异分析来评估医疗补助扩张后的变化.
主要成果:
- 医疗补助扩张增加了扩张州所有体积四分位数的医疗补助覆盖范围.
- 医疗补助患者在体积较小的医院进行手术的几率比在体积较高的中心更高.
- 私人保险患者最有可能在体量最高的中心接受手术.
结论:
- 医疗补助扩张增加了覆盖范围,但并没有改善医疗补助患者获得大量甲状腺切除中心的机会.
- 持续存在的障碍限制了Medicaid患者获得大量手术护理的机会.
- 尽管医疗补助扩张,但获得大量护理的差异仍然存在.
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