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城市医院在医疗保险中的农村地位急剧上升,2017-23年
Yang Wang1, Jared Perkins2, Christopher M Whaley3
1Yang Wang, Johns Hopkins University, Baltimore, Maryland.
城市医院越来越多地声称农村地位的医疗保险补偿福利,导致"行政农村"医院的激增. 这种趋势可能会转移用于真正农村医疗保健提供者的资源.
科学领域:
- 卫生政策 卫生政策
- 医疗保健管理部门的管理.
- 农村健康差异 农村健康差异
背景情况:
- 医疗保险和医疗补助服务中心 (CMS) 在2016年为城市医院引入了双重分类.
- 这一政策使医院能够利用城市和农村的医疗保险名称.
- 这一变化旨在解决影响医院分类的联邦法院裁决.
研究的目的:
- 为了记录2016年CMS政策变化后,行政农村医院的增加.
- 分析双重分类医院的特征和患病率.
- 评估双重分类对农村卫生资源分配的影响.
主要方法:
- 从2017年到2023年对医疗保险成本报告和影响文件的分析.
- 追踪农村和城市双重分类医院的数量.
- 检查医院的所有权 (非营利性与营利性) 和位置.
主要成果:
- 农村行政医院的数量大幅增加,从2017年的3家增加到2023年的425家.
- 双重分类主要是由现有的城市医院推动的.
- 超过75%的双重分类医院是非营利性,包括主要的学术医疗中心.
结论:
- 双重分类政策导致行政目的被指定为农村医院的医院数量大幅增加.
- 这种行政重新分类可能会影响用于地理农村医疗保健的资源分配.
- 政策建议包括将农村卫生计划专门指向位于农村地区的医院.
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