医疗补助家庭和社区服务用户之间的结果比较:私人住宅与私人住宅. 辅助生活设施 辅助生活设施
Hyunjee Kim1, Katherine Courchaine1, Angela Senders1
1Center for Health Systems Effectiveness, Oregon Health & Science University, Portland, Oregon, USA.
在家中使用家庭和社区服务 (HCBS) 的个人比在辅助生活中的人住院的次数更多,住院的天数更少. 政策制定者应该专注于改善家庭HCBS护理质量.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 老年学是一门学科.
- 公共卫生政策 公共卫生政策
背景情况:
- 家庭和社区服务 (HCBS) 对老龄化人口至关重要.
- 了解基于HCBS设置的结果对于护理规划至关重要.
- 双重符合条件的个人 (医疗保险和医疗补助) 是一个重要的用户群体.
研究的目的:
- 为了比较65岁以上的双重符合条件的个人在私人住宅和辅助生活设施中使用医疗补助HCBS的健康结果.
- 为了识别HCBS设置之间的住院,急诊室访问,在家的日子和医疗保健支出之间的差异.
主要方法:
- 使用仪表变量 (IV) 方法来减轻混因素.
- 分析了链接的医疗保险和医疗补助申请数据,从2016-2019年.
- 包括39个州883个县的383,000多名个人.
主要成果:
- 家庭HCBS用户的月入院率较高 (1.3个百分点的增长) 和在家的日数较少 (-0.3天),与辅助生活居民相比.
- 进一步的分析表明,家庭HCBS用户的住院,急诊室访问和医疗补助支出增加的可能性增加.
- 大多数HCBS用户 (85%) 居住在私人住宅中.
结论:
- 家庭HCBS使用者面临的不良健康事件的风险更高,与那些在辅助生活设施.
- 研究结果表明,对于在家接受HCBS的个人来说,需要加强支持和改善护理服务.
- 政策制定者应该考虑采取干预措施,以解决不同HCBS环境之间的结果差异.
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