过渡中的军事卫生系统:重新审视可避免的住院治疗情况 (2021-2024财年)
Mark J Meuer1, Wendy Vaughan1,2, Amanda Banaag1,2
1Center for Health Services Research, Uniformed Services University of the Health Sciences, Bethesda, MD 20814, United States.
Military medicine
|January 20, 2026
概括
与私人初级保健经理 (PCM) 合作的军事受益者,可避免的住院病例较少. 这表明,军事卫生系统 (MHS) 内部的人员短缺可能会影响直接护理能力.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 军人卫生保健 军人卫生保健
- 提高质量 提高质量
背景情况:
- 军事卫生系统 (MHS) 经历了重大转型,包括国防卫生署 (DHA) 合并,MHS GENESIS部署,设施调整和COVID-19大流行.
- 这些变化可能会影响MHS受益者的护理质量和可访问性.
研究的目的:
- 根据他们的初级保健经理 (PCM) 是否在直接护理 (军事治疗设施) 或私营部门,以比较MHS受益人中可避免住院率.
- 评估最近MHS变化对受益者护理质量的影响.
主要方法:
- 一项跨部门研究使用MHS数据库分析了2021-2024财政年度的TRICARE Prime受益人 (18-64岁).
- 卫生保健研究和质量局 (AHRQ) 的预防质量指标 (PQI) 用于识别可避免的住院治疗.
- 使用原始和调整的风险比率以及后勤回归模型来比较直接护理和私营部门PCM之间的结果.
主要成果:
- 总共有490,236例入院病例被分析,其中2.85%与PQI相关.
- 虽然最初的比率表明直接护理PCM的可避免住院病例较少,但调整后的分析显示,私营部门PCM的受益人整体风险较低 (3.75%对2.70%).
- 黑人种族和并发症与更高的可避免住院几率有关.
结论:
- 私营部门PCM管理的受益人显示,可避免住院的几率较低.
- 调查结果表明,人员短缺对MHS内部直接护理能力的潜在影响.
- 稳定MHS对于维持准备好的医疗力量以支持军事准备至关重要.
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