分配但没有定:对加利福尼亚州覆盖的注册人员中初级保健提供者利用率的研究
Barbara Rubino1, Erik Taylor2, Renée Vera Hagen2
1Covered California, Health Equity and Quality Transformation Division, Sacramento, CA, USA. Barbara.Rubino@covered.ca.gov.
Journal of general internal medicine
|January 20, 2026
概括
许多人利用非指定的初级保健提供者 (PCP),尽管市场计划要求. 政策制定者应该鼓励PCP的持续使用,因为43%的持续注册成年人没有初级保健访问.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 医疗保健政策 医疗保健政策
- 主要护理医学 医疗保健
背景情况:
- 高质量的初级保健对健康公平和成本控制至关重要.
- 许多人无法持续地获得通常的护理来源.
- 覆盖的加利福尼亚要求健康计划将入学者分配给初级保健提供者 (PCP),以促进高价值护理.
研究的目的:
- 分析覆盖加利福尼亚州招生人群中初级保健和整体医疗保健利用模式.
- 在各种健康计划类型中检查分配与非分配PCP使用的差异.
主要方法:
- 分析了2022年超过110万名覆盖加利福尼亚州入学者的初级保健利用数据.
- 检查分配PCP,未分配PCP和非初级保健服务的利用率.
- 持续注册的成年会员中医疗保健未使用率的评估.
主要成果:
- 虽然PPO/EPO注册者最初使用PCP的比例较高,但在调整人口统计和临床因素后,差异减少了.
- 在所有计划类型中,对未分配的PCP的访问频繁.
- 显著的43%的连续注册成年人在12个月内没有使用任何初级保健服务.
结论:
- 应该促进对任何初级保健提供者 (PCP) 的一致使用,无论其分配如何.
- 目前旨在将患者转向单一PCP的政策可能比预期的有效率低,因为经常使用非指定的提供者.
- 进一步研究对获得和使用初级保健的障碍是有必要的.
相关概念视频
The Anchoring-and-Adjustment Heuristic
7.7K
In order to make good decisions, we use our knowledge and our reasoning. Often, this knowledge and reasoning is sound and solid. However, sometimes, we are swayed by biases or by others manipulating a situation. For example, let’s say you and three friends wanted to rent a house and had a combined target budget of $1,600. The realtor shows you only very run-down houses for $1,600 and then shows you a very nice house for $2,000. Might you ask each person to pay more in rent to get the...
7.7K
Lipids as Anchors
7.2K
In the plasma membrane, the lipids forming the bilayer can also act as an anchor to tether proteins to the membrane. The three main types of lipid anchors found in eukaryotes are – prenyl groups, fatty acyl groups, and glycosylphosphatidylinositol or GPI groups. Prenyl and fatty acyl groups act as anchors on the cytosolic surface of the membrane, whereas GPI anchors proteins on the extracellular side.
The carboxy-terminal of most of the prenylated proteins, such as Ras proteins, contains...
The carboxy-terminal of most of the prenylated proteins, such as Ras proteins, contains...
7.2K
Anchoring Junctions
4.9K
Anchoring junctions are multiprotein complexes that help cells connect to other cells and the extracellular matrix. Anchoring junctions are present on the lateral and basal surfaces of cells, providing strong and flexible connections. Focal adhesions are often formed due to cell interactions with the ECM substrata, which initiate signal transduction via kinase cascades and other mechanisms. Together, they provide stability and tissue integrity. There are three types of anchoring junctions:...
4.9K
Varicose Veins II: Diagnostic Studies and Interprofessional Care
195
Varicose veins, or varicosities, develop when the valves in the veins, which control blood flow, weaken or damage. It causes blood to pool and the veins to enlarge. Understanding the clinical manifestations, diagnostic approaches, and management options for varicose veins is crucial for effective treatment and relief.Clinical manifestationsClinical manifestations of varicose veins include a heavy, achy feeling or pain after prolonged standing or sitting. This discomfort can often be relieved by...
195
Pulmonary Embolism II: Diagnostic Studies and Interprofessional Care
349
Diagnosing Pulmonary EmbolismDiagnosing pulmonary embolism (PE) involves clinical assessment and advanced imaging tests. The preferred diagnostic tool is the spiral (helical) CT scan or CT angiography (CTA), which uses intravenous contrast media to visualize the pulmonary vasculature and identify emboli.A ventilation-perfusion (V/Q) scan is an alternative for patients unable to receive contrast media. This scan includes both perfusion and ventilation scanning. Perfusion scanning involves...
349
GPI Anchoring of Proteins in the ER Membrane
5.4K
GPI-anchoring is a post-translational, reversible protein modification that is ubiquitous in eukaryotes. Such proteins are primarily present on the exoplasmic leaflet of the plasma membrane.
GPI-anchor structure
A sequence of 11 enzymatic reactions results in the synthesis of the complete GPI anchor consisting of a hydrophobic and a hydrophilic portion. The hydrophobic portion comprises phosphatidylinositol, while the hydrophilic part comprises polar groups like phosphoethanolamine,...
GPI-anchor structure
A sequence of 11 enzymatic reactions results in the synthesis of the complete GPI anchor consisting of a hydrophobic and a hydrophilic portion. The hydrophobic portion comprises phosphatidylinositol, while the hydrophilic part comprises polar groups like phosphoethanolamine,...
5.4K


