医疗保险优势客户服务是最需要更高需求的患者使用的
Denise D Quigley, Ann Haas, Marc N Elliott1
1RAND Corporation, 1776 Main St, Santa Monica, CA 90407.
The American journal of managed care
|August 15, 2024
概括
医疗保险优势客户服务更多地使用的是健康状况不佳,需要更多的医疗保健障碍和医疗保健障碍的人员. 为复杂患者设计服务可以提高质量和健康公平.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 卫生公平研究 卫生公平研究
- 医疗保健管理的管理
背景情况:
- 医疗保险优势 (MA) 计划服务于具有不同医疗需求的多样化人口.
- 了解注册人员与客户服务的参与对于提高计划绩效和成员满意度至关重要.
研究的目的:
- 描述使用客户服务的医疗保险优势注册人员.
- 确定与客户服务使用相关的人口,健康和医疗保健利用因素.
- 为提高MA客户服务的策略提供信息,以更好地满足会员的需求.
主要方法:
- 分析了2022年马来西亚医疗保健提供者和系统消费者评估调查中的259533名医疗保险优势登记者的全国样本.
- 使用权重线性回归模型来评估客户服务使用与受访者特征之间的关联.
主要成果:
- 42%的MA注册者报告说在过去的6个月中使用了客户服务.
- 在一般和心理健康状况较差的受试者以及患有多种慢性疾病的受试者中,客户服务的使用率更高.
- 用户还具有较低的教育程度,收入有限,偏爱英语以外的语言,以及更高的医疗保健利用率.
结论:
- 医疗保险优势客户服务支持人口有更高的医疗保健需求和重要的护理障碍.
- 客户服务应优化为医疗复杂,高需要的患者.
- 在客户服务和解决会员需求的连续性可以提高质量和推进健康公平.
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