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商业管理式医疗的参保者对其健康保险计划的评价与医疗补助管理式医疗的参保者有差异吗?

Do commercial managed care members rate their health plans differently than Medicaid managed care members?

作者信息

Roohan Patrick J, Franko Scott J, Anarella Joseph P, Dellehunt Laura K, Gesten Foster C

机构信息

Bureau of Quality Management and Outcomes Research, Office of Managed Care, New York State Department of Health, Albany 12237, USA.

出版信息

Health Serv Res. 2003 Aug;38(4):1121-34. doi: 10.1111/1475-6773.00166.

Abstract

OBJECTIVE

To determine if members of commercial managed care and Medicaid managed care rate the experience with their health plans differently.

DATA SOURCES

Data from both commercial and Medicaid Consumer Assessment of Health Plan Surveys (CAHPS) in New York State.

STUDY DESIGN

Regression models were used to determine the effect of population (commercial or Medicaid) on a member's rating of their health plan, controlling for health status, age, gender, education, race/ethnicity, number of office visits, and place of residence.

DATA COLLECTION

Managed care plans are required to submit to the New York State Department of Health (NYSDOH) results of the annual commercial CAHPS survey. The NYSDOH conducted a survey of Medicaid enrollees using Medicaid CAHPS.

PRINCIPAL FINDINGS

Medicaid managed care members in excellent or very good health rate their health plan higher than commercial members in excellent or very good health. There is no difference in health plan rating for commercial and Medicaid members in good, fair, or poor health. Older, less educated, black, and Hispanic members who live outside New York City are more likely to rate their managed care plan higher.

CONCLUSIONS

Medicaid members rating of their health care equals or exceeds ratings by commercial members.

摘要

目的

确定商业管理式医疗和医疗补助管理式医疗的成员对其健康计划体验的评价是否存在差异。

数据来源

纽约州商业和医疗补助健康计划消费者评估调查(CAHPS)的数据。

研究设计

使用回归模型来确定人群(商业或医疗补助)对成员健康计划评价的影响,并控制健康状况、年龄、性别、教育程度、种族/族裔、门诊次数和居住地点。

数据收集

管理式医疗计划必须向纽约州卫生部(NYSDOH)提交年度商业CAHPS调查结果。NYSDOH使用医疗补助CAHPS对医疗补助参保者进行了一项调查。

主要发现

健康状况为优秀或非常好的医疗补助管理式医疗成员对其健康计划的评价高于健康状况为优秀或非常好的商业成员。健康状况为良好、中等或较差的商业和医疗补助成员在健康计划评价上没有差异。居住在纽约市以外的年龄较大、受教育程度较低、黑人及西班牙裔成员更有可能对其管理式医疗计划给予更高评价。

结论

医疗补助成员对其医疗保健的评价等于或超过商业成员的评价。

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