解码无家可归:Z-Codes和承认无家可归作为一种共同疾病
Sansrita Nepal1,2, Lawrence A Haber3,4, Sarah A Stella3,4
1Division of Hospital Medicine, Denver Health and Hospital Authority, 777 Bannock Street, Denver, CO, 80204, USA. sansrita.nepal@dhha.org.
无家可归严重影响健康结果和医疗保健利用率. 新的医疗保险和医疗补助服务中心 (CMS) 政策变化要求更好地记录住院患者的无家可归情况,影响报销和护理.
科学领域:
- 公共卫生 公共卫生
- 医疗保健服务研究 医疗服务研究
- 健康 公平 卫生 公平
背景情况:
- 美国有超过653,100人受到无家可归的影响,造成了健康挑战的重大社会决定因素.
- 与住房人口相比,无家可归者 (PEH) 面临更高的住院率,更长的住院时间和更高的医疗保健费用.
- 住院患者中无家可归的患病率明显高于一般社区.
研究的目的:
- 审查"Z代码"用于识别健康的社会决定因素 (SDOH) 的历史使用情况.
- 解释最近的医疗保险和医疗补助服务中心 (CMS) 关于无家可归者文件的政策变化及其对退款的影响.
- 分析新CMS政策对患者,临床医生和卫生系统的风险,益处和实施障碍.
主要方法:
- 对SDOH的历史"Z-code"利用情况的审查.
- 分析最近的CMS政策变化,影响住房无家可归者的记录和住院医院的收费情况.
- 评估与政策变化相关的潜在风险,利益和实施障碍.
主要成果:
- CMS政策提升了在住院护理中记录无家可归者的重要性,直接影响了医疗保健报销.
- 该政策对患者,临床医生和卫生系统具有潜在的风险和益处,需要仔细考虑.
- 需要解决卫生系统内有效实施这一政策的障碍.
结论:
- 卫生系统必须超越仅仅记录无家可归者的范围.
- 迫切需要解决无家可归者 (PEH) 经历的健康不平等问题.
- 需要采取有意义的行动来改善PEH的健康结果.
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