从2012年到2019年,医疗保险受益人中紧急护理利用的趋势
Joel J Mantilla1, Ryan C Burke2,3, E John Orav4
1Herbert Wertheim College of Medicine, Florida International University, Miami.
JAMA network open
|January 26, 2026
概括
老年人紧急护理 (UC) 访问从2012年到2019年显著增加,特别是在城市和较弱势地区. 到2019年,高级实践从业者 (APP) 提供了超过一半的UC访问.
科学领域:
- 老年学是一门学科.
- 医疗保健服务研究 医疗服务研究
- 公共卫生 公共卫生
背景情况:
- 紧急护理 (UC) 中心迅速扩大,但老年人中的使用模式仍未得到充分研究.
- 了解这些趋势对于评估老龄化人口获得和提供医疗保健至关重要.
研究的目的:
- 分析65岁及以上的医疗保险受益人中UC使用趋势.
- 根据社会人口统计和社区特征调查UC使用的变化.
主要方法:
- 一项横截面研究,使用20%的全国收费医疗保险受益者 (2012-2019) 的样本.
- 统计分析包括使用负二项式模型计算未调整的访问率和调整的发病率比率 (IRR).
- 研究了临床医师专业分布的趋势 (初级保健,急诊医学,高级实践从业者 (APP)).
主要成果:
- 在2012年至2019年期间,每年每1000名受益人中,UC访问量从47.7增加到117.2.
- 使用率的增长在老年人群 (85岁以上),符合医疗补助计划的个人以及农村或社会经济弱势社区中较慢.
- 到2018-2019年,农村居民的调整UC利用率比城市居民低45%;那些处于高度不利地区的人的利用率低23%.
- 由APP管理的访问比例从2012年的21.0%上升到2019年的50.8%.
结论:
- 在老年人中,UC使用率显著增加,在城市,较弱势地区的度更高.
- 在紧急护理设置中,APP的作用已经显著扩大,到2019年,APP管理了超过一半的访问.
- 这些不断变化的模式需要进一步研究以患者为中心的结果和护理效率.
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