在俄勒冈州医疗补助计划中实施基于价值的支付改革后,获得严重精神疾病护理的差异
Benjamin Lê Cook1, K John McConnell2, Gareth Parry1
1Cambridge Health Alliance and Harvard Medical School, MA, USA.
Medical care research and review : MCRR
|May 28, 2025
概括
俄勒冈州的基于价值的支付 (VBP) 实施减少了黑人和拉丁裔医疗补助受益人严重精神疾病 (SMI) 护理机会的种族差异. 政策转变改善了这些群体的获取,缩小或消除了以前在护理方面的差距.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 健康 公平 卫生 公平
- 精神卫生保健政策 精神卫生保健政策
背景情况:
- 在获得心理健康护理方面的种族和种族差异不成比例地影响严重精神疾病 (SMI) 的医疗补助受益人.
- 了解政策干预对这些差异的影响对于改善健康结果至关重要.
- 俄勒冈州在2012年实施基于价值的支付 (VBP) 为检查SMI护理获取变化提供了一个案例研究.
研究的目的:
- 评估俄勒冈州成年医疗补助受益人获得严重精神疾病 (SMI) 护理的种族和民族差异.
- 在2012年实施基于价值的支付 (VBP) 后,检查SMI护理获取差异的变化.
- 根据种族和种族,比较VBP实施前后的访问率.
主要方法:
- 使用俄勒冈州医疗补助申请数据从2010年到2019年的描述性研究.
- 使用多变量回归分析来比较SMI护理获取的变化.
- 分析重点集中在VBP实施前和后的实施时期,按种族和种族分层.
主要成果:
- 基于价值的支付 (VBP) 的实施与黑人受益人获得SMI护理的0.28%的增加有关,消除了VBP前的差异.
- 拉丁裔受益者在VBP后获得SMI护理的机会增加了0.34%,缩小了先前存在的差距.
- 白人受益者作为参考组来比较访问变化.
结论:
- 俄勒冈州的VBP政策强调了精神疾病患者的获取和公平,这似乎有助于减少SMI护理中的种族和民族差异.
- 专注于获取和公平的有针对性的政策干预可以有效地减轻弱势群体在心理健康护理方面的差异.
- 进一步的研究可以探索VBP通过哪些特定机制影响公平获得SMI服务的具体机制.
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