在有或没有功能障碍的成年人中,医疗保健利用模式
Sungchul Park1, Jim P Stimpson2, A Mark Fendrick3,4,5
1BK21 FOUR R&E Center for Learning Health Systems, Department of Health Policy and Management, College of Health Science, Korea University, Seoul, Republic of Korea.
JAMA network open
|April 11, 2025
概括
功能障碍的成年人使用更多的医疗服务,包括高价值和低价值的护理. 获得服务,而不仅仅是临床价值,影响了这一群体的使用率.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 关于残疾人的研究.
- 公共卫生 公共卫生
背景情况:
- 功能障碍的成年人有更高的医疗保健需求.
- 了解他们的医疗服务利用率对于公平的护理至关重要.
- 以前的研究还没有完全阐明高价值与低价值服务使用的模式.
研究的目的:
- 调查不同程度的功能障碍的美国成年人中医疗保健利用模式.
- 为了比较高价值和低价值的医疗服务在具有和没有功能障碍的个人之间的使用.
主要方法:
- 对2013-2021年医疗支出小组调查数据的横截面分析.
- 包括18岁以上的非机构化美国平民.
- 通过自我报告的困难 (视力,听力,记忆,流动性,自我照顾,差事) 来评估功能障碍,分类为没有,中度或严重.
主要成果:
- 与没有功能障碍的成年人相比,具有功能障碍的成年人,特别是严重的成年人,表现出更高的门诊访问率和处方填充率.
- 中度/重度残疾的个人增加了使用高价值 (例如,血压测量) 和低价值 (例如,抑郁症的二类药物) 服务.
- 相反,中度/严重残疾组使用的高价值癌症查较少.
结论:
- 功能障碍与整体医疗服务利用率的增加有关.
- 服务的可访问性,不论临床价值,显著影响功能障碍的个人使用.
- 未来的干预措施应考虑需求和获取障碍,以优化对这一群体的护理.
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