医疗保险和医疗补助的双重资格的患者的门诊护理
Joshua M Liao1,2, Paula Chatterjee3,4, Yueming Zhao4,5,6
1Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, TX 75390, United States.
Health affairs scholar
|August 28, 2025
概括
拥有双重医疗补助和医疗保险的个人 ("双重") 获得的门诊服务较少,特别是分专业护理. 针对性干预可以改善这一弱势群体的获取和结果.
科学领域:
- 医疗服务研究
- 医疗保健政策
- 门诊护理
背景情况:
- 双重获得医疗补助和医疗保险的人 (
研究的目的:
- 描述医疗保险和医疗补助的双重资格人士与非双重资格人士之间的门诊护理模式.
- 识别护理提供和实践特征的差异.
主要方法:
- 对2022年医疗保险服务费索赔数据的分析.
- 包括967,820个双元和4,600,486个非双元的临床和地理数据.
- 对106545个诊所的6700万个门诊服务进行了检查.
主要成果:
- 双重资格的个人获得的门诊和子专业服务比非双重资格的个人少.
- 双人医院更频繁地使用初级保健医生和高级专业人员.
- 在传统办公环境中,大多数双重服务是由一个较小,分散的提供者集团提供.
结论:
- 对于双重资格的个人来说,在门诊护理的获得方面存在显著的差异.
- 针对特定的提供者群体和实践类型可以提高双重治疗的治疗效果.
- 需要修改政策和实践来解决这些缺口.
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