创伤伤害后的紧急医疗补助入学预测了长期的医疗保健利用率
Diane N Haddad1, Ella Eisinger, Justin S Hatchimonji
1From the Division of Trauma (D.N.H., J.S.H., D.J.L., J.R., M.J.S., N.D.M., P.M.R., E.J.K.), Surgical Critical Care and Emergency Surgery, and Perelman School of Medicine (D.N.H., E.E., J.S.H., A.T.C., O.I.R., A.U.M., D.J.L., M.K.D., M.J.S., N.D.M., P.M.R., E.J.K.), University of Pennsylvania, Philadelphia, Pennsylvania; and Department of Surgery (L.M.K.), Stanford University, Stanford, California.
The journal of trauma and acute care surgery
|September 3, 2024
概括
新受保患者在受伤后使用更多的医疗保健服务,包括急诊室访问和住院治疗,相比没有保险的人. 然而,仅靠保险在六个月后并没有显著改善身体功能或焦虑水平.
科学领域:
- 创伤外科手术是什么
- 医疗服务研究 医疗服务研究
- 卫生经济学 卫生经济学
背景情况:
- 没有保险的受伤患者面临着更糟糕的结果和灾难性成本.
- 保险连接计划将患者连接到医疗补助,减轻了财务负担.
- 伤害后保险登记对医疗保健利用的长期影响仍未得到充分研究.
研究的目的:
- 检查伤害后保险注册和随后的医疗保健利用之间的关联.
- 为了比较追溯保险 (RI) 患者与连续保险 (Medicaid保险 [MI]) 和未保险患者的医疗保健利用模式.
- 根据保险状况,评估患者在受伤后六个月报告的结果 (PRO).
主要方法:
- 2017-2021年受伤患者 (18-64岁) 的连接创伤登记册和电子医疗记录数据.
- 对30天和12个月内心脏病患者和无保险人群的人口统计,损伤特征和医疗保健利用率 (住院治疗,急救诊所,诊所) 的RI患者进行了比较.
- 在一组患者中分析了6个月的身体功能和焦虑的PRO.
主要成果:
- 将494名RI患者与1,706名MI和148名没有保险的患者进行了比较.
- RI患者年轻,受伤更深入,住院时间更长.
- RI患者在30天和12个月后显著增加ED访问,诊所访问和住院治疗,与未保险者相比 (p < 0.001).
- 多变量分析证实,与无保险人相比,RI与未来更高的ED利用率,住院和专家访问有关.
- 在6个月内,在医疗补助计划覆盖的和没有保险的患者之间,没有发现身体功能或焦虑的显著差异.
结论:
- 伤害后的保险入学增加了未来的医疗保健利用率,而不是没有保险.
- 虽然保险至关重要,但它本身不足以优化护理和改善健康结果.
- 需要进一步的研究来了解保险对患者长期结果的下游影响.
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