在有或没有医疗复杂病情的商业保险婴儿中,医疗保健利用率和成本
Ashlee J Vance1, James Henderson, Zhe Yin
1Author Affiliations: Center for Health Policy and Health Services Research, Henry Ford Health, Detroit, Michigan (Dr Vance); College of Nursing (Dr Vance), Department of Pediatrics, College of Human Medicine (Dr Vance), Department of Obstetrics, Gynecology and Reproductive Biology, College of Human Medicine (Dr Meghea), Michigan State University, East Lansing, Michigan; Institute for Healthcare Policy and Innovation (Dr Henderson and Mr Yin), Department of Internal Medicine (Dr Henderson), University of Michigan, Ann Arbor, Michigan ; and School of Nursing, Yale University, Orange, CT (Dr Costa).
在新生儿重症监护室 (NICU) 住院后,患有医疗复杂疾病的婴儿需要更高的医疗保健利用率和自付费用. 医疗复杂性,而不仅仅是早产,推动了这些增加的医疗保健需求和费用在生命的第一年.
科学领域:
- 医疗保健经济学 医疗经济学
- 儿科健康服务研究 儿童健康服务研究
- 新生儿护理的结果.
背景情况:
- 关于商业保险婴儿在新生儿重症监护室 (NICU) 住院后的医疗保健利用率和成本的数据有限.
- 了解这些模式对于财务规划和资源分配至关重要.
研究的目的:
- 评估新生儿住院治疗后的头12个月的医疗保健利用率和相关成本.
- 为了比较患有和没有医疗复杂疾病的婴儿.
主要方法:
- 使用IBM MarketScan商业数据库 (2015-2019) 进行的回顾性队列研究.
- 包括在NICU出生时住院的婴儿,连续12个月的覆盖.
- 分析了医疗保健的使用情况 (再接收,急救诊所,门诊) 和自付费用.
主要成果:
- 医学上复杂的婴儿显示出更高的再入院率,急诊室访问率和专家利用率.
- 与非复杂婴儿相比,医疗复杂婴儿 (1893美元) 的平均自费费用明显高于非复杂婴儿 (873美元).
- 几乎一半的新生儿在他们的第一年承担了超过500美元的费用.
结论:
- 医疗复杂性是影响婴儿NICU住院后医疗保健使用和支出的一个关键因素.
- 调查结果强调了家庭的经济负担和有针对性的支持的需要.
- 洞察力可以为决策者和提供者提供信息,以应对患有复杂疾病的婴儿照顾的财务挑战.
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