儿童医院护理中的无计划区域化和州际依赖
Urbano L França1,2, Michael L McManus1,2
1Division of Critical Care, Department of Anesthesiology, Critical Care and Pain Medicine, Boston Children's Hospital, Boston, Massachusetts.
新英格兰的儿童医院护理实际上是一个区域系统,严重依赖马萨诸塞州. 这种无计划的相互依赖凸显了潜在的脆弱性和需要区域协调,以确保获得护理.
科学领域:
- 医疗保健系统 医疗保健系统
- 儿科医学 儿科医学
- 医疗保健服务研究 医疗服务研究
背景情况:
- 在美国,儿科医院的整合正在增加.
- 国家越来越依赖邻国提供儿科住院服务.
- 这种州际依赖的程度并没有得到很好的描述.
研究的目的:
- 描述跨州儿科医院的使用模式.
- 量化新英格兰地区儿科护理的州际依赖程度.
主要方法:
- 2019年在新英格兰和纽约的儿科住院患者 (年龄<15岁) 的回顾性横截面研究.
- 排除心理健康,常规新生儿护理和与怀孕有关的入院.
- 分析州外住院情况,住院时间,诊断情况和保险类型.
主要成果:
- 马萨诸塞州提供了该地区71.1%的儿科住院和86.8%的住院.
- 州际护理依赖程度差异很大,从马萨诸塞州的2.0%到新罕布什尔州的65.8%.
- 与医疗补助计划注册者相比,私人保险儿童更有可能获得州外护理.
结论:
- 新英格兰的儿科护理作为一个事实上的区域化系统,具有显著的患者流动和对马萨诸塞州的依赖.
- 这种无计划的相互依赖性会造成系统漏洞.
- 区域规划和正式协调对于可持续获得儿科护理至关重要.
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