退伍军人可能在VHA社区护理网络中看到质量较低的临床医生
Yanlei Ma1, Jessica Phelan2, E John Orav3
1Yanlei Ma, Harvard University, Boston, Massachusetts.
Health affairs (Project Hope)
|January 6, 2025
概括
根据VA MISSION法案,为退伍军人提供社区护理的范围扩大. 然而,质量较差的临床医生更有可能治疗退伍军人,强调需要改善社区护理质量保证.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 退伍军人健康 退伍军人的健康
- 卫生政策 卫生政策
背景情况:
- 2018年"退伍军人事务任务法"扩大了退伍军人获得社区护理的机会.
- 确保为退伍军人提供高质量的社区护理是国家优先事项.
研究的目的:
- 评估VHA社区护理网络中治疗退伍军人的社区临床医生与不治疗退伍军人的社区临床医生之间的质量绩效差异.
- 确定参与退伍军人社区护理的临床医生的特点.
主要方法:
- 对退伍军人卫生管理局 (VHA) 数据和医疗保险绩效评分的分析.
- 对临床医生治疗VHA入学者的质量衡量的比较与不治疗VHA入学者的质量衡量.
主要成果:
- 在2022年,66%的社区临床医生治疗了VHA入学者.
- 治疗退伍军人的临床医生更有可能是男性,经验较少,在小组实践中,在农村/社会脆弱地区.
- 与最高四分位数相比,最低质量四分位数中的临床医生更有可能治疗VHA注册者8.8个百分点.
- 这种模式在初级保健和心理健康方面最为明显.
结论:
- 退伍军人可能会被表现较差的社区临床医生不成比例地治疗.
- 需要联邦战略来确保退伍军人从高质量的社区提供者那里获得护理.
- 针对性质量监督对于VHA社区护理网络至关重要.
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