马萨诸塞州医疗补助ACO计划可能改善了怀孕和产后注册者的护理使用和质量
Megan B Cole1, Jihye Kim2, Sarah H Gordon3
1Megan B. Cole (mbcole@bu.edu), Boston University, Boston, Massachusetts.
Health affairs (Project Hope)
|September 3, 2024
概括
医疗补助负责任照顾组织 (ACO) 改善了孕妇产后访问和查. 然而,这些基于价值的护理模式可能不足以改善总体的孕产妇健康结果.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 孕产妇健康 孕产妇健康
- 以价值为基础的护理
背景情况:
- 基于价值的护理模式,如Medicaid ACOs,旨在提高医疗保健的质量和获取.
- 医疗补助ACO可以改善孕妇和产后患者的护理,这是一个脆弱的人群.
研究的目的:
- 评估Medicaid ACOs对孕产妇护理质量和利用的影响.
- 评估在产前,分娩和产后期间的护理变化.
主要方法:
- 在马萨诸塞州利用全付款人索赔数据进行了一项自然实验.
- 采用差异差异的方法来比较ACO实施前后的时间.
- 分析了Medicaid覆盖的活产儿的护理质量和护理使用情况.
主要成果:
- 医疗补助 (Medicaid) ACO与及时分娩后检查,分娩后抑郁症查和产前/产后办公室检查的增加有关.
- 在严重的孕产妇发病率,早产或急诊室访问方面没有观察到显著的变化.
- 对剖腹产产生的影响是不确定的.
结论:
- 医疗补助 (Medicaid) 的ACO可以增强门诊患者对孕产妇医疗保健的参与.
- 这些模型本身可能不足以改善关键的孕产妇健康结果.
- 将医疗补助ACO扩展到其他州可以改善对母亲护理的准入.
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