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在农村国家医疗复杂性的医疗补助保险儿童
James Bohnhoff1, Chelsea Bodnar2, Jon Graham3
1Department of Pediatrics (J Bohnhoff), MaineHealth, Portland, Maine; Center for Interdisciplinary Population & Health Research (J Bohnhoff), MaineHealth Institute for Research, Westbrook, Maine.
蒙大拿州的医疗复杂性 (CMC) 儿童通常住在专家附近. 然而,患有CMC的美洲印第安人儿童面临着更长的距离到专科护理,突出了获取差异.
科学领域:
- 儿童医疗保健 获得 儿童医疗保健 获取
- 健康差距 研究 研究 研究 研究
- 农村卫生 农村卫生
背景情况:
- 患有医疗复杂性的儿童 (CMC) 是一个需要专门护理的弱势群体.
- 地理障碍和种族障碍可能会对儿童子专科服务的获取产生重大影响.
- 了解CMC的分布及其在蒙大拿州等农村州获得护理的机会至关重要.
研究的目的:
- 根据临床因素,农村和接近专业护理的情况,在蒙大拿州描述患有医疗复杂性 (CMC) 的儿童.
- 确定和量化美国印第安人儿童在地理上获得儿科子专科护理的差异.
主要方法:
- 一项利用2016-21年蒙大拿州医疗补助申请数据的横截面研究.
- 儿童使用儿科医学复杂性算法进行了分类.
- 计算了前往最近儿科子专家的行车时间,并根据复杂性和种族进行了比较.
主要成果:
- 在126,873名儿童中,8.5%被确定为CMC.
- 与非复杂的慢性病 (34分钟) 和没有慢性病 (43分钟) 相比,CMC的平均驾驶时间 (28分钟) 较短.
- 美国印第安人的孩子,无论复杂程度如何,总是比其他种族群体更远离专家.
结论:
- 虽然CMC可能总体上更接近专家,但很大一部分人仍然面临长途旅行.
- 美国印第安人儿童在专科护理方面面临着更大的地理障碍,无论他们的医疗复杂性如何.
- 未来的干预措施应优先考虑改善农村和美洲印第安人CMC的访问.
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