Hill Steven C, Wooldridge Judith
Center for Cost and Financing Studies, Agency for Healthcare Research and Quality, Rockville, Maryland, USA.
J Health Care Poor Underserved. 2003 May;14(2):229-43. doi: 10.1353/hpu.2010.0784.
How well does TennCare, Tennessee's Medicaid managed care program, meet the needs of blind/disabled Supplemental Security Income (SSI) enrollees? People with disabilities have extensive health care needs and greater barriers to accessing care, so efforts to reduce service use may decrease their health and independence. On the other hand, managed care plans may better coordinate care. Computer-assisted telephone surveys of urban SSI and other urban TennCare enrollees were conducted to assess these issues. SSI enrollees in TennCare had mixed experiences, and they faced problems in areas particularly important to people with disabilities. Relative to other TennCare enrollees, SSI enrollees had similar or slightly worse access to care and satisfaction. A significant minority of SSI enrollees reported unmet needs for care, such as not getting referrals to specialists, prescription drugs, and special medical equipment. Lack of care coordination was a problem for some SSI enrollees.
田纳西州的医疗补助管理式医疗项目 TennCare 满足失明/残疾补充保障收入(SSI)参保者需求的情况如何?残疾人有广泛的医疗保健需求,且在获得医疗服务方面面临更大障碍,因此减少服务使用的举措可能会损害他们的健康和独立性。另一方面,管理式医疗计划或许能更好地协调医疗服务。我们对城市 SSI 参保者和其他城市 TennCare 参保者进行了计算机辅助电话调查,以评估这些问题。TennCare 中的 SSI 参保者经历各异,他们在对残疾人尤为重要的领域面临问题。与其他 TennCare 参保者相比,SSI 参保者获得医疗服务的机会相似或略差,满意度也相仿。相当一部分 SSI 参保者报告称存在未满足的医疗需求,比如未获得专科转诊、处方药和特殊医疗设备。缺乏医疗协调对一些 SSI 参保者来说是个问题。