儿科实践与马萨诸塞州医疗补助负责任护理组织的经验
Shriya Jamakandi1, Joan Li2, Alyna T Chien3
1Department of Health Services Policy & Practice (HSPP) (S Jamakandi), Brown University School of Public Health, Providence, RI.
Academic pediatrics
|November 7, 2024
概括
有儿科实践的医疗补助负责任护理组织 (ACO) 寻求解决儿童健康需求并整合社会服务. 然而,与以成人为中心的实践相比,儿科实践报告的合作和政策标准化较少.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 儿科健康政策 儿科健康政策
- 负责的护理组织 负责的护理组织
背景情况:
- 负责任的护理组织 (ACO) 正在发展旨在改善护理协调和质量的医疗保健模式.
- 医疗补助ACO计划越来越多地纳入各种实践类型,包括那些为儿科患者提供服务的人群.
- 了解这些ACO中儿童专注实践的独特经验对于计划的成功至关重要.
研究的目的:
- 调查Medicaid ACOs内的儿科实践的动机和协作经验.
- 为了比较儿童专注的实践与成人专注的实践在Medicaid ACOs的经验.
- 在ACO框架内确定影响儿科护理整合和有效性的因素.
主要方法:
- 这是一项混合方法研究,利用了对三家儿科包括医疗补助ACO领导人的定性访谈以及对马萨诸塞州225名初级保健实践领导人的调查.
- 数据收集发生在2018年和2019年之间,涵盖医疗补助ACO计划内的组织动机和实践层次经验.
- 包括普通最小平方回归在内的统计分析被用来比较儿科和非儿科实践之间的经验.
主要成果:
- 医疗补助 (Medicaid) ACO的领导人与儿科代表旨在倡导儿科关注和整合社会服务.
- 与以成年人为中心的实践相比,以儿科为中心的实践在ACO内部的合作显著减少.
- 政策的标准化,如医生补偿,在以儿科为重点的实践中也不那么普遍.
结论:
- 医疗补助ACO计划中的初始经验可以根据所服务的儿科患者比例而有所不同.
- 专注于儿科的实践在ACO内部的合作和政策标准化方面可能面临着不同的挑战.
- 可能需要量身定制的策略来优化医疗补助 (Medicaid) ACOs中的儿科实践的参与和结果.
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