与患者参与健康和社会需要病例管理计划相关的因素
Christine H Lo1, Margae J Knox2, Elizabeth A Hernandez2
1From the University of California, Berkeley School of Public Health; Berkeley, CA (CHL, MJK, ALB); Contra Costa County Health Services Department, Martinez, CA (EAH). christine.lo@berkeley.edu.
Journal of the American Board of Family Medicine : JABFM
|August 14, 2024
概括
在住房不稳定和某些慢性疾病患者中,患者参与病例管理的比例更高. 案例经理解释了一小部分的参与变化,突出了患者特定的因素.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 健康的社会决定因素
- 医疗保健管理的管理
背景情况:
- 许多有资格获得病例管理服务以满足健康和社会需求的患者没有参与.
- 了解患者特征驱动参与对于计划有效性至关重要.
- 影响参与社会需求案件管理的因素尚不清楚.
研究的目的:
- 识别与参与社会需求病例管理计划相关的患者特征.
- 检查病例经理患者参与度的变化.
主要方法:
- 在2017年8月至2021年2月期间,对43,347名医疗补助受益人提供病例管理的分析.
- 使用了描述性统计和多层次物流回归模型.
- 参与被定义为响应外展和记录所讨论的主题;COVID-19队伍的敏感性分析.
主要成果:
- 39%的符合条件的患者参与了病例管理服务.
- 更高的参与率与女性性别,40岁以上,黑人/非洲裔美国人种族,西班牙裔/拉丁裔种族,无家可归史,慢性疾病和抑郁症相关.
- 病例管理人员解释了患者参与度变化的6%.
结论:
- 住房不稳定和特定医疗状况的医疗补助患者表现出更高的参与度,与更大的需求保持一致,与对援助的接受度相关联.
- 患者的特征,特别是与社会和医疗需求相关的特征,是参与的关键驱动力.
- 病例经理对患者参与度的总体变化贡献最小.
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