无家可归的退伍军人移动医疗单位的利用和成本
Jean Yoon1,2,3, Adam Chow1, Jillian J Weber4
1Health Economics Resource Center, Veterans Affairs (VA) Palo Alto Health Care System, Menlo Park, California.
JAMA network open
|January 30, 2026
概括
移动医疗单位 (MMU) 增加了无家可归退伍军人获得医疗保健的机会,导致更多的初级保健和无家可归服务,但总体成本更高. MMU有效地接触到有复杂需求的弱势退伍军人.
科学领域:
- 获得医疗保健的机会.
- 退伍军人的健康问题
- 无家可归者服务
背景情况:
- 退伍军人事务部 (VA) 无家可归患者医疗团队 (HPACT) 计划部署了移动医疗单位 (MMU),以加强无家可归退伍军人的社区医疗保健.
- 该倡议旨在改善具有重大健康需求的弱势人口的外展和获得护理的机会.
研究的目的:
- 评估MMU实施对门诊和住院医疗保健利用以及无家可归退伍军人相关成本的早期影响.
- 了解MMU服务与医疗保健服务使用和支出变化之间的关联.
主要方法:
- 从2021年10月到2025年3月,在24个HPACT地点进行了一项纵向队列研究.
- 该研究比较了使用MMU护理的退伍军人和接受常规护理的退伍军人的医疗保健利用率和成本 (门诊,住院,总成本),采用差异差异和事件研究模型.
- 敏感性分析包括倾向性得分匹配和不同HPACT地点的比较.
主要成果:
- 使用MMU护理的退伍军人每季度对初级保健,无家可归计划,心理健康密集病例管理和急诊室服务的访问量增加.
- 观察到,因物质使用障碍和家庭护理而住院的患者数量有所减少.
- 每个财政季度的医疗保健总费用增加了1724美元,对于使用MMU护理的患者而言,与通常的护理相比.
结论:
- MMU护理导致门诊服务的适度增加和一些住院护理的减少,以及更高的整体医疗保健成本.
- MMU代表了一种潜在的有效策略,用于吸引无家可归的退伍军人进入障碍和复杂的健康要求.
- 虽然MMU可能不会减少所有急性护理的使用率,但它们可以提高这一群体获得基本服务的机会.
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