相关实验视频
在管理护理中注册的老年患者的获取和结果
D G Clement1, S M Retchin, R S Brown
1Department of Health Administration, Virginia Commonwealth University, Richmond 23298-0203.
JAMA
|May 18, 1994
概括
卫生维护组织 (HMO) 的医疗保险患者与收费服务 (FFS) 计划相比,获得护理和结果的情况各不相同. 关节疼痛的HMO入学者有更多的访问,但胸痛患者的访问较少,整体症状改善较少.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 相对有效性研究研究比较
- 医疗保险政策 医疗保险政策
背景情况:
- 卫生维护组织 (HMO) 和服务费 (FFS) 代表了医疗保险受益人提供医疗保健的不同模式.
- 了解这些模型之间的护理获取和结果的差异对于评估医疗保健质量和患者满意度至关重要.
研究的目的:
- 为了比较医疗保健获得和医疗结果的医疗保险患者经历急性或慢性症状在HMOs注册与FFS计划.
- 为了确定两个支付模式之间的护理利用率和症状反应的具体差异.
主要方法:
- 1990年,在医疗保险受益者中进行了一项家庭电话调查,这些受益者在过去12个月内报告关节或胸部疼痛.
- 一个分层的随机样本包括6,476名HMO入学者和6,381名可比的FFS受益者.
- 关键措施包括寻求护理的行为,医生访问,手术,处方,后续建议和症状反应.
主要成果:
- 与FFS非登记者相比,关节疼痛的HMO登记者更有可能去看医生和处方.
- 胸部疼痛的HMO注册人比FFS非注册人更少地去看医生.
- 对于这两种情况,HMO注册者较少见专家,接受随访或进行进展监测,关节疼痛的症状改善较少.
结论:
- 具有医疗保险风险合同的HMO在特定的门诊条件下使用服务减少.
- 与FFS受益者相比,在关节疼痛的HMO入学者中观察到的症状改善较少.
- 调查结果表明,Medicare患者的HMO和FFS模型之间在护理获取和患者报告结果方面存在潜在的权衡.
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