国家对医疗补助产妇护理合同的范围
Caitlin Murphy1, Anne Rossier Markus1, Rebecca Morris1
1The George Washington University.
The Milbank quarterly
|June 12, 2024
概括
由于缺乏国家标准,医疗补助管理护理合同对孕产妇健康是零碎和不完整的. 开发一个最佳实践工具可以帮助各州为改善产妇护理质量和公平性创造更明确的期望.
科学领域:
- 公共卫生 公共卫生
- 卫生政策 卫生政策
- 孕产妇健康 孕产妇健康
背景情况:
- 孕妇的健康受到整个怀孕和产后护理的质量和可获得性显著影响.
- 医疗补助计划 (Medicaid) 覆盖了美国近一半的分娩,利用管理护理提供产妇服务.
- 目前的医疗补助管理护理合同往往缺乏全面的孕产妇健康标准,阻碍了持续的质量和公平.
研究的目的:
- 调查州医疗补助机构如何在管理护理中签订产妇健康服务合同.
- 评估现有合同在多大程度上包含基于证据的孕产妇健康最佳实践.
- 了解国家对孕产妇健康合同的方法.
主要方法:
- 一项三阶段研究,包括对母亲健康最佳实践的文献综述.
- 对来自40个州和华盛顿特区的托管护理合同进行了审查.
- 与四个州医疗补助机构的采访.
主要成果:
- 确定了近60种孕产妇健康最佳实践,但它们在多个来源中分散.
- 医疗补助合同不完全和不一致地解决了孕产妇健康连续性的问题.
- 国家采用"有机"",故意"或"有根据"的方法来承包孕妇健康.
结论:
- 缺乏综合的,全面的指导方针使得孕产妇健康的承包复杂化.
- 建议制定"最佳实践工具",以帮助国家制定明确的合同期望.
- 标准化合同可以通过医疗补助管理护理改善孕产妇健康的获取,质量和公平性.
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