退伍军人健康管理局是否购买高质量的家庭医疗保健?
Katherine A Kennedy1, Frank DeVone1, Portia Y Cornell2
1Transformative Health Systems Research to Improve Veteran Equity and Independence (THRIVE) Center of Innovation, Providence VA Healthcare System, Providence, RI, USA.
概括
退伍军人通过VA合同获得高质量的家庭医疗保健 (HHC). 然而,与城市同行相比,农村退伍军人面临的挑战是获得高质量的机构,因为有更中立的质量选择.
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:
- 退伍军人往往需要在住院后获得熟练的家庭医疗保健 (HHC).
- 获得高质量的护理对于康复和福祉至关重要.
- 基于地理位置,在医疗保健获取方面可能存在差异.
研究的目的:
- 评估退伍军人在医院出院后获得VA承包的家庭卫生机构 (HHA) 的质量.
- 在农村和城市地区的退伍军人之间比较获得高质量的HHA的机会.
- 评估VA承包HHA的质量,相对于一个县所有HHA的质量.
主要方法:
- 使用国家VA数据进行的回顾性观察研究 (2015年4月至2019年9月).
- 包括退伍军人医疗中心 (VAMCs) 退伍军人医疗中心 (VAMCs) 退役军人医疗中心 (VAMCs) 退役军人医疗中心 (VAMCs) 退役军人医疗中心 (VAMCs) 退役军人医疗中心 (VAMCs) 退役军人医疗中心 (VAMCs) 退役军人医疗中心 (VAMCs) 退役军人医疗中心 (VAMCs) 退役军人医疗中心 (VAMCs) 退役军人医疗中心 (VAMCs) 退役军人医疗中心 (VACs) 退役军人医疗中心 (VACs) 退役军人医疗中心 (VACs) 退役军人医疗中心 (VACs) 退役军人医疗中心 (VACs) 退役军人医疗中心 (VACs)
- 计算质量比率 (QR),将高质量的 (4或5星级) VA 承包的 HHAs 与每个县的所有高质量 HHAs 进行比较,并通过 VAMC 汇总.
主要成果:
- 在113个VAMC中分析了42,010名退伍军人的60,406次HHC发作.
- 虽然61.1%的VAMCs具有高QR,但只有27.3%的农村退伍军人服务.
- 与城市退伍军人 (64.0%) 相比,农村退伍军人获得高质量的HHAs的机会较低 (46.3%),中性质HHAs的比例较高.
结论:
- 与VA签订合同的HHA通常比所有可用的HHA提供更高质量的护理.
- 服务于农村人口的VAMC显示,获得高质量的HHA的机会较少.
- 这种差异归因于农村地区更容易获得中性质的HHA,而不是与质量较低的机构签订优惠合同.
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